OOP Costs Seen for Some Seeking Emergency Care After Sexual Assault

Average emergency department charges were $3,551; charges for victims of sexual abuse highest during pregnancy
woman female patient hospital
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MONDAY, Sept. 19, 2022 (HealthDay News) -- An estimated 16.0 percent of persons who seek emergency department care related to sexual assault are expected to pay the costs out of pocket, according to a letter to the editor published in the Sept. 15 issue of the New England Journal of Medicine.

The Violence Against Women Act (VAWA) of 1994 mandates that persons seeking care after sexual assault should not be charged for the evidence-gathering portion of their medical care, but they are billed for diagnostic testing, laceration repair, counseling, prevention of sexually transmitted diseases and HIV infection, and emergency contraception. With that in mind, Samuel L. Dickman, M.D., from Planned Parenthood of Montana in Billings, and colleagues examined charges that were billed at hospital-based visits to emergency departments with at least one diagnosis code that was associated with sexual violence.

Sexual violence was a coded diagnosis for an estimated 112,844 emergency department visits in 2019. The researchers found that the expected payer was Medicaid and private insurance for 36.2 and 22.1 percent of visits, respectively, while 16.0 percent of patients were expected to pay out of pocket. The average emergency department charges were $3,551; the highest charges were seen for victims of sexual abuse during pregnancy ($4,553). The average charge for self-pay patients was $3,673.

"Broadening the provisions of the VAWA to cover therapeutic services, not just evidence collection, would help some survivors avoid financial hardships," the authors write. "More extensive reforms, including universal health care coverage, are needed to ensure that costs are not a barrier to essential medical care and forensic evaluation in cases of sexual assault."

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