Victim compensation
Financial compensation from the Victim Compensation and Assistance Division (VCAD) of the Attorney General's Office is available to victims of crime, including sexual assault. Experienced staff within this Division assist victims in understanding their rights as a crime victim, determining what expenses may be eligible for compensation, and assessing what other resources are available to them.
The MA Attorney General’s Office (AGO), Executive Office of Health and Human Services (EHHS), Executive Office of Safety and Security (EOPSS), and MA Hospital Association (MHA) have worked together to ensure that post-assault sexual assault care including forensic examinations are provided to victims at “no cost” as required by Violence Against Women Act (VAWA) Reauthorization Act of 2013 (see www.congress.gov/bill/113th-congress/senate-bill/47 for more information).
As of March 2016, MA hospitals are allowed to directly bill the VCAD for all Emergency Department (ED) expenses incurred as the result of a sexual assault that involve a patient whose assault occurs in Massachusetts and who receives a forensic sexual assault examination at a Massachusetts hospital. While a patient’s primary health care can be used if the patient affirmatively opts in, direct billing to VCAD should be implemented for patients who have privacy/confidentiality or other concerns about their primary health insurance being billed. Hospitals may not bill patients for any co-payments or other patient-incurred costs related to their primary health insurance and those should be submitted to the VCAD. (See Coverage and Billing Procedures for Sexual Assault Exams in Massachusetts (PDF) | (DOC).)
Direct billing process
Direct billing by hospitals can be submitted for expenses incurred “from the time the patient enters the ED until they are discharged from the ED.”
Inform the Patient that:
- Victim’s Compensation may be used to cover the cost of forensic exam/evidence collection and other emergency department expenses whether or not they choose to report their assault to police.
- Direct billing is facilitated through the hospital; the patient should request direct billing and is not required to use their personal health insurance to cover their ED care.
- While a patient’s health insurance may be billed as an alternative, it is highly recommended that direct VCAD billing is utilized to minimize additional stress or privacy/confidentiality concerns for the patient.
- All billing information will be submitted to VCAD and any records submitted to the Division are considered confidential and cannot be released without the consent of the claimant or as a matter of law.
- Minor patients are eligible for Victim’s Compensation. If they receive a bill in error, they should contact the VCAD for assistance.
Expenses covered with direct billing
- Forensic exam/evidence collection with the MA Sexual Assault Evidence Collection Kit (MSAECK)
- Labs, imaging, medications (including HIV nPEP starter packs)
- Physician fees
- ED nursing and ancillary costs
- Facility fees/room and board
To facilitate the direct billing process
- The SANE should provide the patient’s MSAECK number to the Primary Nurse to include on the form (known as Attachment B) that is submitted to VCAD as part of the direct billing process.
- Faxing the patient’s MSAECK form 2A (PSCR) to EOPSS helps to ensure that the patient’s sexual assault is considered “reported” and acts as a safeguard if there is a problem with the direct billing process
- Ensure that the MSAECK number is on form 6 “Discharge Form” for patient’s future reference
Additional compensation eligibility
Patients are also eligible for up to $25,000 compensation (beyond coverage for ED expenses) for additional expenses related to the patient’s sexual assault. Such expenses include:
- 28 day prescription for HIV nPEP medications
- Medical follow-up services
- Counselling
- Loss earnings
To Be Eligible for Additional Compensation, patients must complete and submit the Victim’s Compensation Application (located in the Patient Information Envelop) within the MSAECK within three years of their assault. The application can also be found at the following site: www.mass.gov/massachusetts-victims-of-violent-crime-compensation. The SANE should provide the patient with their MSAECK number for inclusion on the application. Often the rape crisis advocate will assist the patient to complete the application.
Sexual assaults occurring outside of Massachusetts
If the patient’s assault occurred out of state, patients are not eligible for compensation from the MA VCAD but may be eligible for compensation from the state where the assault occurred. Patients should be directed to the MA VCAD for guidance and assistance with this process. The SANE should provide the VCAD brochure (located in the MSAECK Patient Information Packet) as a reference.
Patient declines MSAECK or patient ineligible for MSAECK
Patients who decline a forensic exam or whose assault occurred >5 days may be eligible for Victim Compensation but are required to report their assault to the police within 5 days of the assault. In these circumstances, patients must submit a copy of their police report with their Victim Compensation Application. Patients can receive further guidance in this regard by contacting VCAD.