R270-1-20. Medical Awards

  Pursuant to Subsection 63M-7-511(4)(b), medical awards are subject to limitations as follows:

  (1) All medical costs must be related directly to the victimization and all treatment must be considered usual and customary.

  (2) The reparations officer reserves the right to audit any and all billings associated with medical care.

  (3) The reparations officer will not pay any interest, finance, or collection fees as part of the award.

  (4)(i) If the claimant has no medical insurance or other collateral source for payment of the victim's medical bill, the office shall pay 60% of billed charges for eligible medical bills.

  (ii) If the claimant has medical insurance or another collateral source for payment of the victim's medical bills, the office shall pay the portion of the eligible medical bills that the claimant is obligated to pay pursuant to the insurance agreement.

  (iii) This rule does not apply to expenses governed by R270-1-5 or R270-1-23.

  (5) This rule supersedes any other agreements regarding payment of medical bills by the office.

  (6) Child endangerment examinations for children that have been exposed to drugs shall be paid for when the health and safety of the child is at risk and no other collateral source is available. The cost of the exam needs to be an expense incurred by the victim. The writing of evidentiary reports and any form of lab testing shall not be covered as part of the examination.