For 25 years, the federal Violence Against Women Act has required any state that wants to be eligible for certain federal grants to certify that the state covers the cost of medical forensic exams for sex assault victims. Such people can’t be required to participate with law enforcement to get an exam; nor do they have to pay anything out-of-pocket for that exam at any point. Yet for some people who have been raped, the bills keep coming despite this long-standing federal prohibition and other state laws that provide additional financial protections in many places, reports Kaiser Health News for NPR. “There’s often a disconnect between the emergency room personnel that take care of the person and the billing department that sends out the bills,” says Jennifer Pierce-Weeks of the International Association of Forensic Nurses.
There is wide variation in how states meet their financial obligations to cover sexual assault exams (often called “rape kits”) that collect evidence of the crime. Many states tap funds they receive under the federal Victims of Crime Act. Others use money from law enforcement or prosecutors’ budgets. What services are covered as part of the rape exam can vary by state as well. Federal rules require that the patient be interviewed and examined for physical trauma, penetration or force, and that evidence be collected and evaluated. Many states include additional services without charging victims, including testing and treatment for pregnancy or sexually transmitted diseases. Some may cover treatment for counseling, or for injuries that survivors experience during the assault. New York requires that patients treated for sexual assault receive some free services beyond the federal requirements, including emergency contraception and treatment for STDs.