What is the Medical Provider Forensic Rape Examination (“FRE”) Direct Reimbursement Program?

What is the Medical Provider Forensic Rape Examination (“FRE”) Direct Reimbursement Program?

New York State Executive Law (§631.13) provides for direct reimbursement by the Office of Victim Services (OVS) to providers of forensic sexual assault examination services. The law requires the medical provider to explain the victim's billing choices to them. When a victim chooses to have the provider bill OVS directly for the forensic examination and its related charges, the provider shall use the Direct Reimbursement Program. Direct reimbursement from OVS to providers of forensic examination services ensures that a sexual assault survivor will not have to pay for her/his own forensic examination, an added stressor after a highly traumatic event.

The forensic examination reimbursement fee is currently the amount of itemized charges not exceeding $800, and is intended to cover the forensic examiner’s services, facility services related to the forensic examination including the costs of equipment, materials and supplies required for the gathering of forensic evidence, as well as laboratory testing and pharmaceuticals related to a sexual assault forensic examination.

Follow-up HIV post-exposure prophylaxis (PEP) costs beyond the initial 3-day period (effective 11/27/2012, the initial supply to be paid under the FRE will be a 7-day dose pack) and the costs of medical treatment for injuries incurred as a result of the sexual assault, as well as any long-term pharmaceuticals related to the sexual assault other than HIV PEP are NOT intended to be covered by the FRE direct reimbursement program and will continue to be reimbursed through the victim/patient’s insurance, Medicaid, other insurance program, or if the victim chooses to file a full OVS claim application, according to previously-established OVS procedure as a payer of last resort.

If you have questions about any of the above, contact the Office of Victim Services at [email protected] or at 1-800-247-8035 or TTY: 1-888-289-9749.

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