West Virginia Code of State Rules › Agency 64 - Health › Title 64 - LEGISLATIVE RULE WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES › Series 64-84 - Medical Examiner Requirements for Postmortem Inquiries › Appendix A

Current through Register Vol. XLI, No. 28, July 12, 2024
STATE OF WEST VIRGINIA
DEPARTMENT OF HEALTH
OFFICE OF THE CHIEF MEDICAL EXAMINER
AGREEMENT FOR PAYMENT OF FEES FOR SERVICES
				  INVOICE
TO: DATE: RE:
Fees authorized by law; W. Va. Code §
										16-1-11, Fees for Services,
				  64CSR51, and Medical Examiner Requirements for Postmortem Inquiries,
				  64CSR84
___ Staff/M.D./PH.D. Testimony (or deposition) out of
				  the office:
$_____________
Minimum fee of $1,000 (for up to 2 hours), and $500 per each
				  additional hour, or fraction thereof.
Other Staff:
$300/hour (64CSR84,
				  §28).*
____
Staff/M.D./Ph.D. Deposition, in office:
$500 per hour, or fraction thereof (64CSR84, §28). $_____________
____
Consultation in office:
$400/hour, or
				  fraction thereof (64CSR84, §28).*
____
Use of autopsy suite:
$1,000/hour or
				  fraction thereof (64CSR84, §27).* $_____________
____
Use of OCME Office for deposition:
$300/hour or fraction thereof (64CSR84, §27).* $_____________
____
Cremation Permits:
$50 per case (W. Va.
				  Code §
									61-12-9 and 64CSR84, §13.8).*
				  $_____________
____
Histology Services:
microscopic slide
				  re-cuts: $50 per slide (64CSR84,
				  §21.8.c).$
______________
____
Copying x-rays:
$50/film (64CSR51,
				  §§4.3 & 4.4). $_____________
____
Photocopying, duplication, etc.:
$0.50/page
				  (64CSR51, §§4.3 & 4.4). $_____________
____
Post-mortem Examination Reports to Family:
a report of autopsy or external examination and toxicology report (64CSR84,
				  §19.5) will be sent to authorized family member for a fee of $15, upon
				  written request.
$_____________
____
Post-mortem Examination Reports
				  (Notarized):
$300 per case (64CSR84, §19.5)
$_____________
(Report of autopsy or external examination and toxicology
				  report)
____
Photograph copying:
$2.00 per photograph or
				  $30 per CD (64CSR51, §§4.3 & 4.4).$_____________
____
Civil Request: Viewing of OCME material:
$100/hour, or fraction thereof (64CSR84, §27) $_____________
____
Autopsy Wet Tissue Specimen and Body Fluid
				  Storage:
The OCME stores samples for 1 year at no cost. Longer storage
				  beyond 1 year may be requested for a fee of $500 every 3 months, requiring a
				  letter of request (64CSR84, §27); Requestor must submit timely written
				  request and the additional fee payment for each quarter year of additional
				  storage desired or the specimen(s) will be discarded. $_____________
____
Medico-legal Investigation Training Course: $$
				  Varies per course.
Registration per attendee based on location and
				  associated services required; $50 processing fee for regular registration
				  cancellation; late cancellation (within two weeks of conference) - 50% of
				  registration will be withheld; and for cancellation during or after conference
				  - registration payment is non-refundable. $_____________
CRM/05/20/13 Total Due:
$_____________
Office of the Chief Medical Examiner
619 Virginia Street, W.
Charleston, WV 25302
Phone (304) 558-6920 FAX (304) 558-8492
Authorization
:
The Office of the Chief Medical Examiner has established fees
				  for a number of services provided by this Office in accordance with our
				  authority under W. Va. Code §
									16-1-11 and §
									61-12-3
et seq.
as well as two Bureau for Public Health legislative rules: Medical Examiner
				  Requirements for Postmortem Inquiries, 64CSR84, and Fees for Services, 64CSR51.
				  The service(s) you have requested are subject to these fees.
Payment
:
Please do not send
				  cash
.
Please make check payable to the Office of the Chief
				  Medical Examiner and mail to 619 Virginia Street, W., Charleston, W. VA. 25302.
				  Please record the name of the decedent on your check. Please note that the OCME
				  reserves the right to require expected fee payment prior to performing
				  requested services. Cancellations should be made within 48 hours or the fee
				  will be non-refundable.
Payment must be received before services
				  will be rendered (excluding * services)
.
Rendered
				  Services
:
For services rendered before payment is received the below
				  authorization must be signed:
I hereby agree to pay the Office of the Chief Medical
				  Examiner as invoiced for the above-
mentioned service. Invoice to be prepared upon completion of
				  services.
Authorized Signature:
				  _____________________________________________________
Title of Person Signing:
				  ___________________________________________________
Date:
				  _________________________________________________________________
Office of the Chief Medical Examiner
619 Virginia Street, W.
Charleston, W. VA. 25302
Phone (304) 558-6920 FAX (304)
				  558-8492