A Portland-area woman is suing Kaiser Permanente over a bill for a sexual assault forensic exam that she underwent last January.
The complaint, filed earlier this month in Multnomah County Circuit Court, accuses Kaiser Permanente and its Oregon and Washington health plans of negligence and of inflicting distress on Zoe Amos by charging her for the exam after officials at Kaiser Permanente Sunnyside Medical Center in Clackamas said it would be covered by a state fund for sexual assault victims. The fund -- the Oregon Sexual Assault Victims’ Emergency Medical Response Fund -- was set up under the Oregon Department of Justice to give victims a choice about paying for an exam after an assault. If they choose to have the provider pay, that saves them the distress of getting billed and reminded of the experience, advocates say.
“Access to a sexual assault medical-forensic exam is a critical access point to health care services and long-term healing for survivors following a sexual assault,” said Michele Roland-Schwartz, executive director of the Oregon Sexual Assault Task Force, a Keizer-based nonprofit that works with the Oregon attorney general’s office. “Hiccups in that process - like billing a survivor for an exam - interrupts that healing and adds an additional layer of unnecessary stress and worry. Hospitals have an obligation to mitigate trauma for their sexual assault patients by ensuring their systems are responsive, trauma-informed, and non-punitive.”
Kaiser Permanente declined to comment on the suit.
Kaiser Permanente has billed the fund only once -- in July 2019 -- since it was set up in 2003, according to Department of Justice officials. In nearly 40 other instances, victims who'd been billed by Kaiser approached the fund for reimbursement, they said. Kaiser did not file for reimbursement between January and May of 2020, when Amos was first billed for the exam.
Amos went to the Sunnyside hospital’s emergency room on Jan. 18, 2020, less than 24 hours after the assault, the complaint says. Officials repeatedly told Amos she would not be charged for the exam or the emergency contraception she received if she elected to have Kaiser bill the fund, it says. Amos instructed Kaiser to do so, the suit says.
Under Oregon law, a health care provider who has been instructed to bill the fund for a sexual assault exam, contraception or medication for sexually transmitted diseases or actually bills the fund may not bill the victim or the victim’s insurance carrier, the suit says, citing Oregon statute OAR 147.397. This is actually an administrative rule, not a statute
Amos did not have any other services performed in the emergency room besides the forensic exam, was not treated for any injuries and did not have any blood drawn, the lawsuit says.
In April or May, Kaiser billed her for $1,886.15 for services rendered on Jan. 18, according to the complaint. After insurance payments and deductions, it said she owed $1,049.71.
In June, Amos received another bill from Kaiser for the same amount for services on Jan. 18, the complaint says. This bill detailed the charges, including $1,483 for emergency room use and $312.05 for emergency contraception -- both of which are covered by the fund, according to the Justice Department.
Then in August, Amos received a bill from a collection agency, which tacked on $40.64 in interest, the complaint says.
Amos replied to the collection agency with a certified letter in September that contested the debt.
She didn’t hear anything else about it, but in March 2021 when she called the collection agency to find out what happened, she learned that in November 2020 Kaiser had marked the $1,049.71 as “BAD DEBT, COPAY UNCOLLECTIBLE.”
The lawsuit accuses Kaiser of “unlawfully billiing victims for provision of sexual assault forensic examinations in Oregon, contrary to federal and Oregon law.”
“As a result of defendants’ actions, plaintiff has suffered or will suffer in the future: severe mental and emotional anguish; pain and suffering; shame; mental or nervous shock; anxiety; and depression,” the suit says.
It seeks $65,000 in noneconomic damages and $200 in statutory damages.
You can reach Lynne Terry at [email protected].
I know of sexual assault survivors who went to OHSU and to Planned Parenthood. OHSU charged the patient $1200 just for the lab tests, and Planned Parenthood billed the federal government for the services/lab work they did. In neither case did the provider inform the patient or their advocates that there was a fund they should have been billing. The low income family wasn’t able to pay OHSU’s enormous bill, so they paid a little bit every month, but OHSU still sent them to collections for not paying the bill fast enough.