Report: Wis., 11 other states have charged rape victims for medical tests
State group says more work needed despite seeing improvements
MADISON, Wis. — An investigation finds rape victims are getting charged for medical tests they thought were free, and Wisconsin is among more than a dozen states that have issued these charges to sexual assault survivors.
Late last year, Christine was sexually assaulted. She went to a suburban Chicago hospital for a rape kit, which is a medical exam that checks for injuries and collects evidence of the crime. The next day she felt victimized all over again, because she said she got bills for thousands for dollars.
Federal law says that victims should not pay for rape kits, but there can be additional medical charges, like HIV tests or emergency rooms fees that may be not covered. In some states that means victims could be stuck with the bill.
“When you keep getting re-victimized once a month you get a reminder in the mail, ‘Hey, you were raped. Hey, this happened,’ you know, it’s hard to move on,” Christine said.
Chicago’s rape victim advocates helped Christine, but it took 10 months for the bills to stop.
“We have a full-time staff person, and the bulk of their workload is resolving medical bills,” said Sarah Layden, director of Advocacy Services at Rape Victim Advocates.
A CBS News investigation found 13 states where advocates say some rape survivors are getting billed for medical services. In Louisiana, one victim was among those billed after a private company took control of the state-owned LSU Hospital System.
The victim reported being billed around $2,000, and insurance didn’t cover any of it.
State legislators began hearings last month and Louisiana’s governor signed an executive order aimed at better protecting victims.
“I believe that the victim should never be charged,” Louisiana Secretary of Health and Hospitals Kathy Kliebert said.
There have been at least two attempts to change federal law to expand coverage beyond rape kits. Both failed to pass Congress.
There are signs of improvement in Wisconsin.
The Wisconsin Coalition Against Sexual Assault says it’s receiving fewer reports of victims getting bills associated with the forensic exam, but said there is more work to be done.
Breakdown of other states:
Arizona is one of the six states where who pays for the medical forensic exam varies by county. The State Coalition to End Sexual Violence says the rule can lead to inconsistency and confusion over what is covered, so some survivors get billed for medical care. The coalition has hired someone to study the problem further.
Kansas is another one of the six states where who pays for the medical forensic exam varies by county. Advocates said they see survivors being billed for costs related to medication, testing and treatment of injuries.
South Dakota is another one of the six states where who pays for the medical forensic exam varies by county. Advocates said the inconsistency results in some survivors being billed.
Nebraska is another one of the six states where who pays for the medical forensic exam varies by county. Advocates cited several examples of survivors being billed in just the last six months.
State law in Nevada requires the counties to pay for all care for the first 72 hours, but advocates say in the smaller counties they have heard from survivors who have gotten bills.
The Ohio Alliance to End Sexual Violence said the law in Ohio needs to change. The payment situation varies county-to-county and even hospital-to-hospital, which can result in survivors being billed for any costs that exceed the $532 paid by the state.
There seems to be agreement that change is needed in Louisiana. State officials are developing a plan to have the state’s victims’ fund cover the costs of the forensic medical exam, and they are pledging to work with legislators to get it done in the next session.
Advocates in Pennsylvania said their system works fairly well. Survivors have the option of using their own insurance or having the state cover the exam as well as related testing and medications. If additional care is needed and the victim reports the attack, the victim can apply for reimbursement from a state fund.
Maryland hospitals are not supposed to bill for medical costs related to the forensic exam, but the State Coalition Against Sexual Assault said there is confusion about what costs are covered; for example, some survivors have been billed for an ambulance ride, testing or follow-up care. A state panel studying the issue is set to have its first meeting this week.
Christine’s bills apparently stemmed from a clerical error that listed her as self-pay. The Illinois Department of Public Health said they investigate reports of errant billing and encourage people to notify them if it happens.
In California, victims who report their attack to police can seek reimbursement from a state fund. But advocates said some survivors who choose not to report do receive bills for medical treatment related to their rape kit.
Just last summer, Colorado changed its laws setting aside state funds to cover the medical costs associated with forensic exams after some victims received bills. The Colorado Coalition Against Sexual Assault said more than 120 people sued the new program.
Minnesota is another one of the six states where who has to pay for the exam varies by county. While the law says all reasonable expenses should be covered, advocates said there is a lack of consistency statewide, leading to some survivors receiving bills.
The Texas Coalition Against Sexual Assault said they hear “with frequency” from survivors surprised by a bill. State law considers them responsible for costs deemed purely medical. A state fund will reimburse what insurance doesn’t cover, but only if the victim reports the crime and cooperates with law enforcement.
Florida’s Council Against Sexual Violence said billing issues are rare, as rape crisis centers in the state are increasingly developing non-hospital-based exams, which means no hospital bills. Those rape crisis centers are often able to advocate for free medication for survivors, but that is not guaranteed under state law.