The WI SAFE Fund (English) (Spanish) can reimburse health care providers for the cost of a forensic medical exam for victims of sexual assault.
The SAFE Fund can reimburse medical providers when a victim:
Does not wish to report the crime to law enforcement
Does not wish to cooperate with law enforcement
Does not wish to submit the bill to insurance provider
Does not wish to submit bill or any portion of bill to other available payer source (i.e. patient, guarantor, guardian, etc.)
Victim and/or guardian does not have insurance
The Fund may be able to pay for the sexual assault forensic exam, evaluation, testing and medications related to the assault. The fund cannot cover the cost of medical treatment or follow up evaluations.
It is the responsibility of the health care provider to request reimbursement from the SAFE Fund.
The medical provider must submit a Request for Payment form and an itemized bill to the Department of Justice.
Reimbursement will be made directly to the health care provider.
The health care provider may not bill the victim or the family of the victim for the cost of a SANE exam.
Should a victim receive a bill for a SANE exam, they must contact the health care provider immediately and ask them to submit the bill to the SAFE Fund.
A victim must meet one or more of the following criteria:
- Victim did not wish to report crime to law enforcement
- Victim does not wish to cooperate with law enforcement
- Victim does not wish to submit bill for exam to insurance provider or other available payer source
SAFE Fund Statute 949.20
SAFE Fund Administrative Rules
- Collection of the victim’s medical history
- Collection of a forensic history of the events of the assault
- Physical examination of the victim for evidence of the assault
- Photographs of the physical evidence of the sex offense, if the health care provider conducting the examination has been trained to take photographs for use as evidence
- Evaluation, testing, and prophylaxis for sexually transmitted diseases
- Evaluation of the risk of pregnancy
- Collection of blood and urine using the collection kit provided by law enforcement (this does not include drug testing conducted by the medical facility)
- Cost for the use of the medical facility for the examination
- It is the responsibility of the health care provider to request reimbursement for the cost of the SANE exam.
- A health care provider may not bill the victim, or family of the victim, for any of the examination costs, identified above.
- A health care provider seeking SAFE Fund reimbursement shall provide an itemized bill with individual charges listed for each reimbursable charge, along with a SAFE Fund request for reimbursement form.
- Only one itemized bill shall be submitted for each examination.
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Should a victim receive a bill for a SANE exam, they should contact the health care provider and ask them to submit the bill to the SAFE Fund.
- The Department of Justice will make payment directly to the health care provider.
- The Department of Justice will pay two-thirds of the amount billed for eligible services, up to a maximum of $1,578.60 for each examination.
- Exceptions: The Department of Justice may approve an award in excess of the maximum amount, if the health care provider submits evidence that the maximum amount did not fairly and equitably compensate it for the costs incurred in conducting the examination.
- Beginning January 1, 2017, the maximum amount of an award shall be adjusted annually by the “inflation factor” as defined in s. 79.05(1)(am) Stats., and certified by the department of revenue under s. 79.05(2m), Stats.
Please contact safefund@doj.state.wi.us
, with SAFE Fund billing questions.