Florida Administrative Code › 2 - DEPARTMENT OF LEGAL AFFAIRS › 2A - Division of Victim Services and Criminal Justice Programs › Chapter 2A-3 - SEXUAL BATTERY CLAIMS › Section 2A-3.002 - Applicant and Payment Procedures

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				Bureau of Victim Compensation pays for medical expenses connected with the
				initial forensic physical examination of a victim of sexual battery as defined
				by Section 794.011(1)(h),
				F.S., or a lewd or lascivious battery or molestation as defined by Section
				800.04(4) or
				(5), F.S.
(2) Payments are awarded regardless of
				whether the victim is covered by health or disability insurance. The victim
				must not be billed directly or indirectly for expenses associated with the
				examination.
(3) Payments are not
				contingent on the victim's participation in the criminal justice system or
				cooperation with law enforcement.
(4) The claim form and invoice must be filed
				and received by the department within 120 days of the forensic examination.
				Corrections or technical defects on the claim form or invoice shall not result
				in a change to the original filing date for purposes of complying with the
				filing deadline. Failure to submit a properly completed claim form and invoice
				will result in denial of benefits.
(5) The claim form and invoice shall be
				mailed to the Office of the Attorney General, Bureau of Victim Compensation,
				PL-01, The Capitol, Tallahassee, FL 32399-1050; faxed to (850)414-6197 or
				(850)414-5779; emailed to VCIntake@MyFloridaLegal.com, or submitted via the
				department's web portal. The form BVC100SB, Sexual Battery Forensic Examination
				Claim Form revised 11/19, is adopted and incorporated by reference at the
				following address:
http://www.flrules.org/Gateway/reference.asp?No=Ref-12144
.
				A copy of said form can be obtained at
www.myfloridalegal.com
or by contacting
				the Office of the Attorney General, Bureau of Victim Compensation.
(6) For a faxed claim form and invoice to be
				timely received, the transmittal cover page must provide sufficient information
				to identify the claim for which payment is sought, and bear a faxed date stamp
				that is within 120 days immediately following the examination.
(7) Payment shall not exceed $500 with
				respect to any violation. Separate invoices submitted for payment consideration
				of a single examination shall be divided in accordance with the direction and
				discretion of the department.
(8)
				The claim form shall include the following:
(a) The victim's name;
(b) Optional demographic data for statistical
				purposes, including date of birth, race/ethnicity, gender, and national
				origin;
(c) The date the sexual
				battery or lewd or lascivious battery or molestation as reported by the
				victim;
(d) Indication whether or
				not the victim has reported the incident to law enforcement, and if so, what
				law enforcement agency took the report, and the case/report number, if
				applicable;
(e) City, county, and
				state where the crime was committed according to the victim's
				statement;
(f) Whether or not the
				crime occurred while the victim was incarcerated or in custody;
(g) The date the examination was
				completed;
(h) Forensic facility
				information which includes the name of the facility where the examination was
				performed, the facility's federal tax identification number, mailing address
				and telephone number including the area code;
(i) Forensic examiner information which
				includes their name, title, and license number;
(j) Certification by the forensic examiner to
				affirm that the initial forensic physical examination for which the claim is
				based was performed for the purpose of collecting forensic evidence from the
				victim on the date identified using practices consistent with the established
				Adult and Child Sexual Assault Protocols; and,
(k) The signature of the forensic examiner
				and date of signature;
(l) Name,
				federal tax identification number, payment remittance address, email address,
				and telephone number of the medical provider seeking reimbursement;
(m) Medical provider billing representative's
				name, title, acknowledgement from the representative that they have reviewed
				the medical records proving the examination occurred; and,
(n) Affirmation from the medical provider's
				billing representative that the information presented is correct and payment
				for services is outstanding.