Seven. That’s the number of notices an unnamed woman in New York received from a hospital seeking payment—hundreds of dollars, in fact—for the forensic rape exam she endured after being assaulted in 2015. According to an investigation launched by the New York attorney general’s office, she wasn’t the only one who was illegally billed for her rape kit.
During a news conference yesterday, attorney general Eric Schneiderman, standing with several victim advocates by his side, announced that dozens of sexual assault survivors had either received a bill for their rape exam at Brooklyn Hospital or had their insurance provider charged without being notified. Investigators determined that out of the 86 rape exams the hospital had conducted between January 2015 and February 2017, 85 were improperly billed for. Additionally, some of those cases even went to collections.
“This is intolerable conduct,” Schneiderman said, “and it’s hard to imagine the heartbreaking anxiety that would come from having to fight a collections agency over a clearly unlawful, mistakenly charged rape kit.”
According to a study published earlier this year, insurance providers and sexual assault victims paid more than $9 million in 2013 for related medical services. The average rape cost was $6,737, of which most was covered by insurance—but victims on average had to pay $948 out of pocket.
In addition to the investigation’s findings, the attorney general also announced a settlement agreement with Brooklyn Hospital that would ensure sexual assault survivors who are treated there are never billed for their rape kits. Going forward, survivors will receive a form informing them of the option to either have their exams billed to the state’s Office of Victims Services or their private insurance. It’s an agreement, Schneiderman said, they “hope will provide a model to other medical institutions.” He added that the office is looking into the policies and procedures at other hospitals across the state.
“In recent months we’ve begun a long overdue reckoning with our culture of violence and silence. Today’s announcement is really a response to a systemic failure of many American institutions to protect women."
“I would be remiss if I didn’t acknowledge that the challenges facing these survivors are a part of a larger system of discrimination and really a manifestation of a culture of male supremacy in our healthcare system and in the nation as a whole,” Schneiderman said. “In recent months we’ve begun a long overdue reckoning with our culture of violence and silence. Today’s announcement is really a response to a systemic failure of many American institutions to protect women… We must reimagine a world where predators are exposed and held to account and survivors are supported and empowered at every level.”
Activists are applauding the attorney general’s attention to this issue—which is particularly important because it “bolsters” survivors’ experiences, says Josie Torielli, the assistant director of intervention programs at the NYC Alliance Against Sexual Assault. The Alliance actually worked with the woman who helped initiate the attorney general office’s investigation, she adds. “We only worked with one person; one person found us.” Just think, she continues, “about all the other people who maybe don’t know about the Alliance, or don’t know about rape crisis services, or don’t know the exam is supposed to be free.”
Undergoing a rape kit can be immensely challenging, even when hospital staff treat survivors with care and kindness, Torielli says. “And so receiving a bill for that and then receiving repeated reminders and having a collections agency come after you, it’s hideous.”
Brooklyn Hospital—which, according to its Twitter profile, is “in the business of keeping Brooklyn healthy”—released a statement yesterday in response to the attorney general’s announcement. In it, they attributed the illegal rape kit billing, and subsequent retraumatization of victims, to “an inadvertent breakdown in our billing processes,” which they “deeply regret.”
Torielli says she wonders if the experience of this survivor and others like her could have been avoided if Brooklyn had a hospital-based rape crisis program. “When I worked at New York Presbyterian, every sexual assault case that came through, we were reviewing that chart to make sure the person was getting the services they need—so the counseling, advocacy, the after-care, the medical treatment. But an important part of that too was reviewing the billing and making sure the billing department knew that that person shouldn’t receive a bill for those services.”
Imagine, Torielli says, how differently things might have turned out “if there had been an internal program in place for this person that was watching the system to make sure it didn’t fail her.”