Compensation may be available to cover the costs for the emergency medical care a victim received during a sexual assault exam at a hospital.
Once your application is approved, we will work with you to determine what emergency medical care costs are eligible for compensation.
Emergency Medical Care is the care provided at a hospital at the time a sexual assault exam is requested. This covers the medical care necessary to stabilize, treat, or transport the victim at the time of the exam. The medical care may be provided before an exam begins or at any time during the exam.
What Emergency Medical Care Costs Are Covered?
The costs of emergency medical care for victims of sexual assault may be covered if a sexual assault exam was conducted at a hospital after August 31, 2015.
A sexual assault exam includes two parts:
- Medical care for the evaluation and treatment of injuries
- Forensic evidence collection to be used in the investigation of the criminal case
This exam is also called a forensic medical exam for sexual assault. By law, victims are only responsible for the medical care costs from the exam. These medical costs may be eligible for compensation.
If You Are Eligible, You Have Two Options for Compensation
There are two types of compensation:
- Crime Victims’ Compensation (CVC)
- Emergency Medical Care Compensation - Sexual Assault Exam
You will use the same application to apply for the two types of compensation.
Crime Victims' Compensation (CVC)
This option allows you to apply for compensation for all eligible crime-related costs, including payment of the medical costs from the exam. To receive compensation for these costs, you must meet all CVC eligibility requirements. See eligibility requirements here.
Emergency Medical Care Compensation
This option allows you to apply for compensation for only the emergency medical care you received during a sexual assault exam at a hospital after August 31, 2015. To receive compensation for these costs, you do not need to meet all CVC eligibility requirements. With this option, you will not be considered for compensation for any other crime-related costs, such as follow-up medical care, mental health care, or lost wages. See eligibility requirements here.
If you change your mind, you may apply for Crime Victims’ Compensation within three years of the date of crime.
Who May Receive Compensation?
Victims who received emergency medical care related to a sexual assault exam or claimants who paid for the victim’s emergency medical care costs may be eligible for compensation.
Total compensation is limited to $50,000.
CVC is the last source of payment by law. If the victim is seeking only Emergency Medical Care Compensation, the victim must use Medicaid or Medicare if it is readily available – private insurance does not have to be used.
As your application is being processed, be prepared to provide copies of:
- Itemized medical bills
- Receipts for paid bills
- Insurance Explanation of Benefits (EOB) (if insurance was used)
- Insurance card (showing coverage effective date)
We will tell you what documentation to mail to CVC and when.
Information for Medical Providers
Once the service is provided and the application is approved, the medical provider may submit to CVC for payment. The bill(s) must be itemized and should include the victim’s CVC claim number.
Medical bills must be submitted on either a Center for Medicare and Medicaid Services Health Insurance (CMS 1500) claim form or a Uniform Bill (UB-04) claim form with a copy of the EOB from the insurance provider if insurance was used.
The CMS 1500 or UB-04 must include:
- A patient’s name and address
- Date(s) of service
- Type(s) of service(s) provided (diagnosis and procedure codes)
- A billed amount
- A provider’s license number, federal tax identification number (FEIN or SSN), business address, telephone number, signature or signature stamp, and billing dates
- Collateral source information
The bill(s) on the CMS 1500 and UB-04 forms and any accompanying documentation should be sent to CVC:
Crime Victim Services
P.O. Box 12198
Austin, Texas 78711-2198