Two weeks ago, WFAE reported hospitals weren’t being reimbursed for sexual assault exams, according to the nurses at those hospitals. Now, the federal government is reviewing whether North Carolina is correctly following the Violence Against Women Act.
Marnie Shiels, an attorney for the Department of Justice's Office on Violence Against Women, was concerned when she heard nurses say the state was asking for unnecessary information about rape victims such as case numbers from police agencies and detailed medical records.
“We will be reaching out to the state administrator for North Carolina, and then beginning the conversations to find out what is, in fact, happening what are their policies and procedures,” Shiels said.
Part of Shiels' job is making sure states are following the Violence Against Women Act. The law, originally passed in 1994, was intended to improve criminal justice responses for victims of domestic violence and sexual assault. Starting in 2009, states could no longer require victims to pursue a rape case with police in order to reimburse hospitals for doing the forensic exam because victims aren’t allowed to be billed.
Shiels has looked into other states that were accused of not complying with the federal law. Each state has its own way of reimbursing hospitals. If the state uses federal dollars, Shiels needs to make sure it’s adhering to the law. If the state isn’t and doesn’t make changes to fix the problem, she could withhold money.
“We would freeze the funds,” she said.
Shiels said that doesn’t happen frequently.
“Not very often but it has happened a few times.”
The Department of Public Safety is in charge of reimbursing hospitals for the sexual assault evidence kits in North Carolina. The department has not made anyone available for an interview despite multiple requests. The Assistant Director of Victims Services at the Department of Public Safety Liddie Shropshire said in a statement her office is responding to inquiries from the Office on Violence Against Women and is continuing to process claims for reimbursement.
The statement continues, "The Office is committed to funding forensic medical examinations for rape victims at no cost."
But in the two weeks since WFAE aired its first story about this problem, Cathy Rossi, who works with the sexual assault nurse examiner program at Cone Health in Greensboro, says there’s been a noticeable change.
“It’s absolutely been night and day. It’s amazing. The contact and communication from the state has increased dramatically,” Rossi said. “They are being responsive and answering questions. We have cases that were denied in 2017 that are being reviewed now to verify that it was an appropriate denial.”
Rossi said payments for the kits nearly came to a halt about a year and a half ago. Her health system covers six hospitals in three counties and she estimated the hospital hadn’t been paid for about 100 patients. If the state had fully reimbursed the hospital, that could be as much as $80,000. But she said checks are coming in and the state has stopped asking for more information the hospitals weren’t required to provide.
"They haven’t requested any more medical information," Rossi said. "Nor have they given us any reason to give them more detailed info about law enforcement reports."
Rossi is relieved that the denials have stopped and that the state is working with the hospital to resolve these outstanding payments.
Shiels said the delayed payments aren’t likely a violation of the Violence Against Women Act, as long as victims aren’t being billed. But she added if the delays are causing sexual assault nurse examiner programs to close down, that is a serious issue for access to care.