June 4, 2014 — Some rape survivors are still required to pay for medical services related to their assaults, including care related to sexually transmitted infections or pregnancy, according to a new study from the Department of Justice's National Institute of Justice, Kaiser Health News reports.
NIJ funded the study, which was conducted by the Urban Institute, George Mason University and the National Sexual Violence Resource Center.
Researchers surveyed state and local sexual assault service providers and organizations that fund medical forensic exams, sometimes called "rape kits," to determine which medical services were included and if they were offered free of charge. The researchers also conducted case studies in six states.
The 2005 reauthorization of the Violence Against Women Act (PL 109-162) included provisions designed to ensure that rape survivors are not charged for MFEs, regardless of whether they reported the crime to law enforcement or participate in legal proceedings. Instead, the legislation directed federal and state victim compensation funds to cover those costs.
In 2013, Congress again reauthorized VAWA (PL 113-4), this time adding provisions to ensure that rape survivors cannot be required to pay for the tests up front, with the expectation that they will seek reimbursement from insurers.
Federal law also requires MFEs to include a patient interview and history, an examination for physical trauma, and collection of evidence. It does not require that MFEs include tests for pregnancy or STIs.
The study found that most states provide MFEs at no cost to survivors and without any requirements that they report the crime to police. In addition, the study found that hospitals that incorrectly billed patients for such services usually corrected the mistake quickly and redirected the billing to the appropriate state agency.
However, the study also found that a "patchwork" of state laws governing what MFEs should include can create financial difficulties for rape survivors, KHN reports. While many states covered pregnancy and STI tests, they often did not include related treatment for those conditions or injuries sustained during the rape.
In addition, the study found that some states have capped the amount that they will pay for an MFE or related services. While hospitals will often cover some of those costs, some states leave patients liable for those expenses. Survivors can use their health insurance, but many are reluctant to submit claims related to rape out of fear that their family members will have access to the documents (Andrews, Kaiser Health News, 6/3).