An investigation by New York's attorney general found that the Brooklyn Hospital Center improperly billed dozens of patients for the cost of forensic rape exams.The exams, known as rape kits, are required by state law to be free of cost to patients. Attorney General Eric Schneiderman's office said Tuesdaythat between January 2015 and February 2017, the hospital conducted 86 forensic rape exams. It billed the patient or her insurance plan in 85 of those cases, without revealing that the exam could be free.Schneiderman said he launched the investigation after one victim complained that she had been billed seven times for a forensic rape exam performed at the hospital's emergency room. After receiving the initial bill, the patient contacted a victim's assistance organization, which reached out to the state's Office of Victim Services, which told the hospital that the state should be billed. A month later, the patient got a bill from a collection agency."These kits are used on what is undoubtedly one of the worst days of a survivor's life," Schneiderman told The Associated Press. "The absolute last thing they should have to worry about is how they'll pay for their care at the hospital. But we have found contrary to law that way too often they do have to worry."Schneiderman said the state had reached a settlement with the Brooklyn hospital, which dictates that the hospital maintain a Sexual Assault Victim Policy that prevents improper billing and provide full restitution to those who should not have been billed. He said he had also sent letters to 10 other hospitals in the state, seeking information on their policies.The Violence Against Women Act, reauthorized by Congress in 2005, requires that the full out-of-pocket costs of sexual assault medical forensic exams be covered by a state or other entity, as a condition of receiving federal grants through a program calledSTOP. That program provides funding for law enforcement and prosecutions in combating violence against women as well as for victim services. Victims cannot be required to file law enforcement reports to receive free exams.New York is not the only place where victims have been improperly billed. CBS News reportedin 2014 that victims in 13 states said they had been billed for medical services related to a sexual assault. A victims' advocate organization in Chicago told CBS it got as many as six calls a month from rape victims who had been wrongly billed.In 2014, the Urban Institute published a study on how the funding for sexual assault exams is handled by states. "In practice, each state (or local jurisdiction, in the case of non state-level paying systems) decides what it will cover as part of the free exam," the report found. "Some states cover only what is required by federal mandate, and other states provide more free services to victims."The report's authors explain that VAWA 2005 dictates that such exams should, at minimum, include:
- Examining physical trauma
- Determining penetration or force
- Interviewing the patient
- Collecting and evaluating evidence
But the victim may require medical services for treatment relating to an injury, pregnancy or sexually transmitted infections. Whether and how those expenses are covered varies by state, and some victims are billed for the additional services.The Urban Institute study found that crime victim compensation funds were the primary funding sources for the exams in most states, rather than federal STOP grants.And, the report said, there are issues with using victim compensation funds to pay for rape kits: