Profiteering hospitals hit new low: billing and dunning women for rape tests


NY Atty Gen Barbara Underwood

Profit-hungry hospitals have dived to some real lows in billing and mistreating patients. Seven New York facilities have gotten slapped down by the state attorney general for breaking the law by charging more than 200 women anywhere from $46 to $2,892 for collecting evidence that the patients may have been raped.

New York Attorney General Barbara Underwood, whose office conducted a year-long investigation of the abuses of state laws aimed at protecting victims of sexual violence, said in a statement, quoted by the New York Times: “Survivors of sexual assault have already gone through unfathomable trauma. To then subject them to illegal bills and collection calls is unconscionable.”

Hospitals that reached a civil settlement with Underwood’s office, agreeing to pay fines and restitution, included: New York-Presbyterian/Columbia University Medical Center, Richmond University Medical Center, Brookdale University Hospital and Medical Center and St. Barnabas Hospital.

Under New York law, the newspaper reported, hospitals must “provide services to sexual assault victims free of charge. The hospitals are supposed to bill the state Office of Victim Services for rape kits, unless victims choose to have the hospital bill their insurers. But the attorney general’s office found the hospitals were not only billing some patients for collecting evidence, but then sometimes were billing their insurers as well. Some of the unpaid bills were even handed over to debt-collection agencies.”

Underwood said her office started investigation the hospitals for violating the law after a victims’ advocacy group complained about a woman who was billed seven times for a rape test and had her unpaid charges turned over to a collection agency.

The District of Columbia and Virginia have established legal protocols about the collecting and payment for evidence-gathering and testing in rape cases. Maryland lawmakers in the 2018 session tackled the topic, ordering officials to clarify, establish, and figure how to fund rape tests, so victims do not bear their costs.

Although the New York cases have attracted attention and due criticism, women’s advocates and medical researchers say that insurers and hospitals too often fail female patients with fees and charges for medical services when they are brought in for care after apparent sexual assaults.

As the Reuters news service reported:

The Violence Against Women Act, passed in 1994 and reauthorized in 2013, requires states to pay for sexual assault forensic exams, known as rape kits. However, hospital billing procedures often include more services than those associated with the rape kit alone, and forensic costs also vary by state.

Reuters said that women often required hospital admission and stays, for which insurers were charged. They may need pain medication, antibiotics, HIV prevention drugs, emergency contraceptives, or sleep or anxiety drugs.

Teen Vogue, citing a study published in 2013 a public health journal, reported that for women patients involved in sexual assaults:

[N]early all of them paid healthcare costs — an average of about $950 — for crimes committed against them. The study found that while insurance typically covers 86 percent of the $6,737 average cost of rape, including for items like a rape kit — an involved exam that collects forensic evidence for a tailored treatment program or to support court proceedings should you wish to prosecute — survivors are generally left to cover the remaining amount out of pocket. Between antibiotics, sleep aids, anti-anxiety medications, emergency contraceptives, and other related treatments, the study showed some survivors accrued up to $8,900 in charges in the first month alone.

In my practice, I see the not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, effective, and excellent medical care. Health insurance plays a critical role in sharing the risk, cost, and burden of medical calamities that, for all of us, may be a heartbeat away. But political partisans insist the government has no role to play in health care, and, further, that individuals should shoulder any problems on their own.

That’s wrong, most Americans agree. They would argue that, in the wealthiest nation in the world, health care is a right, not a privilege. Further, most of us agree that it is a good idea for taxpayer support for victim funds and to assist those harmed in crimes.

How do big hospitals miss that message, and how venal can their staff and administrators be, turning women’s heartbreak  into just another flurry of bills that must be taken care of, or else? How could can any person in care-giving  believe it’s a good idea to dun a woman, repeatedly, for rape testing? How long will hospitals persist with their sick billing practices that include hounding of sick and injured patients for payment? Enough’s enough, hospitals, and regulators and lawmakers must step up to halt rampant abuses.

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