Iowa Admin. Code r. 61-9.83 - Computation of sexual abuse examination payments

(1) Payment for examination. The department shall make payment for sexual abuse examinations, as appropriate, for services including but not limited to:

a. Examiner's fee:

(1) To collect the patient's medical history;

(2) To conduct a physical examination;

(3) To collect laboratory specimens; and

(4) To test for sexually transmitted diseases.

b. Treatment for the prevention of sexually transmitted disease.

c. Examination facility, including:

(1) Emergency room, clinic room or office room fee;

(2) Pelvic tray and medically required supplies;

(3) Additional facility or equipment fees that the department determines to be reasonable.

d. Laboratory collection and processing of specimens for criminal evidence, sexually transmitted disease, and pregnancy testing.

(2) Provider payment. Any sexual assault forensic examination performed or any sexual abuse services provided by a qualified provider within the first 30 days after a sexual abuse will qualify the provider to receive a $400 provider fee and the $300 facility fee. Qualified providers serving sexual abuse patients with follow-up care will receive a $200 provider fee and a $300 facility fee, if it applies. Services provided by nonqualified providers will only be reimbursed the $300 facility fee, if it applies. Qualified providers are sexual assault nurse examiners as well as other professionals, including doctors of medicine or doctors of osteopathic medicine, advance registered nurse practitioners, and physician assistants who meet or exceed the Iowa standards for sexual assault nurse examiners (more information can be found in rule 61-9.79 (915)). For this purpose, an individual does not have to be certified by IAFN to be a qualified provider. Additionally, child protection centers (CPCs) in Iowa that have been accredited by the National Children's Alliance or equivalent accrediting body will be reimbursed by the state at a rate equivalent to that of those individuals who meet or exceed the Iowa standards for sexual assault nurse examiners. The medical exam shall be completed within 30 days of the disclosure of sexual abuse to the CPC. A qualified sexual assault nurse examiner shall also be reimbursed for travel at the per-mile rate established by the department of administrative services for state employees using a privately owned vehicle for state business. No reimbursement will be provided until the appropriate reimbursement invoice and the sexual assault forensic examination consent form are submitted. Any charges in excess of these amounts will require additional documentation from the provider. The crime victim assistance program will pay only those charges determined by the department to be reasonable and fair.

(3) Examination kits available at no cost. The section makes sexual abuse examination kits available to health care providers at no cost.

Notes

Iowa Admin. Code r. 61-9.83

Amended by IAB July 31, 2019/Volume XLII, Number 3, effective 9/4/2019 Adopted by IAB November 13, 2024/Volume XLVII, Number 10, effective 12/18/2024