The cost of rape may be incalculable—but this wasn’t supposed to be part of it.

New York hospitals illegally billed survivors for hundreds of forensic rape examinations, a new investigation by state Attorney General Barbara Underwood finds.

In a deal first shared with Glamour, seven hospitals have signed a settlement with Underwood’s office to pay back sexual assault survivors who were charged for their rape exams and to set up new policies to keep it from happening again.

“Survivors of sexual assault have already gone through unfathomable trauma; to then subject them to illegal bills and collection calls is unconscionable,” Underwood said in a statement provided to Glamour. “Hospitals have a fundamental responsibility to comply with New York law. My office will continue to do everything in our power to protect survivors and their rights.”

The seven hospitals in the settlement, according to the attorney general: Brookdale University Hospital Medical Center, Columbia University, Montefiore Nyack Hospital, NewYork-Presbyterian Brooklyn Methodist Hospital, NewYork-Presbyterian Columbia University Irving Medical Center, Richmond University Medical Center, and St. Barnabas Hospital.

Settlement documents reviewed by Glamour said the hospitals didn’t admit or deny breaking the law, but that they agreed to repay patients who were improperly billed and also to adopt written policies that make clear survivors are not to receive bills for rape exams.

New York law says hospitals that provide services to sexual assault survivors—including forensic exams, commonly called rape kits—are supposed to send bills directly to the state’s Office of Victim Services (unless a patient chooses otherwise).

That system is supposed to protect survivors’ privacy by making it less likely that a relative or employer might learn they sought medical help. The added layer of confidentiality ideally encourages more people to agree to undergo the exams—which means more physical evidence that can help police find attackers.

But the new investigation found that in the case of these hospitals, that process went awry.

Instead, at least 200 forensic rape examinations conducted by the health care providers were billed to patients or their insurance companies. Amounts ranged from approximately $46 to $3,000, an Underwood aide said. The hospitals also repeatedly failed to inform survivors about their billing options, according to the settlements. In some cases, the bills were sent to collection agencies whose job it was to chase down the outstanding balance.

Last year the New York attorney general’s office settled with Brooklyn Hospital after an investigation that started when a patient came forward to say she had been billed—not once, but seven times—for care associated with a sexual assault case.

Underwood is the first woman to serve as New York attorney general. She took over the state’s top law enforcement job on an interim basis earlier this year after Eric Schneiderman resigned amid a flurry of accusations of abusing women, which he publicly contested. In this year’s midterm elections, New Yorkers elected Letitia James to become the first black woman in state history to fill the role. James will take office in January.

It remains to be seen whether the New York settlement will encourage fresh investigations or changes in hospital and clinic rape-kit billing elsewhere, but the problem is not new, with past controversies reported from Arkansas to Alaska.

For now, Underwood’s office encourages anyone with questions about their New York hospital billing to contact its health care bureau at 800-428-9071.

Celeste Katz is senior political reporter for Glamour. Send news tips, questions, and comments to celeste_katz@condenast.com.

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