September 25, 2014
Rape victims billed for medical expenses
In Louisiana, victims of sex crimes often are billed for forensic medical exams and related care even though state and federal guidelines require many of these services be provided at no cost to the victim. An advocate and victim spoke with the Times Picayune l NOLA.com about this issue.
She was questioned, prodded and photographed over the course of six hours. Nurses collected samples of tissue and fluid from her mouth and her body. They took her urine, drew her blood and bagged her clothes. They offered her drugs to prevent pregnancy, HIV and other sexually transmitted diseases. Then, they led her to a private shower and sent her home.
Her life, she felt, was now divided into two eras: Pre-rape and post-rape. Eight days into the shock of this new reality, she received a letter she couldn’t comprehend.
The cost of some of the medical services she received totaled nearly $2,000, it said. Insurance would pay $1,400. She would owe the remaining $600 — for her share of the cost of two HIV drugs and two other medications designed to stave off side-effects of those drugs.
She folded the papers, stuffed them in her purse and tried to calm down. A few days later, another bill would arrive, showing an additional $1,700 in charges for her care, including an $860 fee for her visit to the emergency room.
“You never really think, ‘Is rape covered by insurance?'” the New Orleans woman said. NOLA.com | The Times-Picayune does not generally identify victims of sexual crimes.
The letter from the hospital was no aberration. In Louisiana, victims of sex crimes often face paralyzing bills for forensic medical exams and related care, even though state and federal guidelines require that many of these services be provided at no cost to the victim. And there’s little continuity in how rape victims are treated from parish to parish and hospital to hospital.
While the state’s Crime Victims Reparations Fund does permit victims to apply for reimbursement for some medical expenses, there are strict limitations regarding who can qualify, including a requirement that the victim file a police report. Research by the U.S. Department of Justice indicates nearly two-thirds of sex assault victims don’t ever go to law enforcement.
Victim advocates worry that prohibitive costs will only increase the likelihood that rape victims will suffer quietly without seeking the medical assistance they may need.
“Sexual assault is already one of the most underreported crimes, period,” said Amanda Tonkovich, a counselor at New Orleans Family Justice Center and coordinator of the New Orleans Sexual Assault Response Team. “Even if people don’t want to report, we want them to come to the hospital and make sure they’re OK, medically speaking.”
By the Numbers: Sexual Assault Forensic Evaluations
Estimated number of sexual assaults committed against women age 12 and older in the United States each year Forcible rapes reported to Louisiana law enforcement in 2012 Rapes reported to New Orleans Police Department in the first quarter of 2014 Fraction of all sexual assault victims who, it is estimated, report their attacks to police Sexual assault victims who are injured during their attacks who end up receiving medical care States that statutorily prohibit health care providers from charging sex assault victims for the sexual assault forensic exam. (Louisiana is not one.) States that cover the cost of pregnancy tests for sex assault victims States that pay for emergency contraception such as Plan B for sexual assault victims States that pay for tests for sexually transmitted infections States that pay for medication prescribed in the course of the forensic exam of a sexual assault victim States that pay for hospital and emergency room fees States that pay for treatment of injuries related to sexual assault States that pay for victim counseling following a sexual assault In New Orleans, rape victims were once examined for free
Last year, a New Orleans college student awoke nude in a public place, disoriented and fearing she had been drugged and raped. Emergency officials responded to the scene and urged her to let them take her to the hospital.
She hesitated. She just wanted to go home. She also worried the hospital charges would appear on insurance statements and alarm her parents, whose health plan she was on. But, she said, the responders convinced her there would be no charge.
A year later, a letter appeared in her campus mailbox informing her that she owed $2,254.
“When I first saw it, I was confused,” she said. “It was a known policy that you won’t be charged. … To have it just pop right back into my life, it was hard.”
At Interim LSU, where trained nurses see about 20 to 25 sexual assault patients per month, nurses until recently were instructed to reassure victims they would not be billed. Although the public hospital was not required by law to do so, it for years absorbed the costs of these exams and all the related medical expenses, area sexual assault victim advocates said.
“Now that’s changed,” Tonkovich said. [ … ]
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