State officials and anti-sexual assault advocates say they are appalled that some rape victims are receiving hefty hospital bills for their treatments after being attacked. They vow to repair that law.

“We go to the hospital with the victims. The last thing we want to be talking about is financial responsibility,” Mary Claire Landry, director of the New Orleans Family Justice Center, said Friday. “As a state, we need to do something about this if we want rape victims to come forward and report these crimes.”

Louisiana’s laws and regulations are inconsistently applied around the state, not only on whether hospitals can bill but on what services they bill. Some hospitals are charging rape victims for expenses such as emergency room care, pregnancy testing, HIV testing and medications as well as treatment of injuries. The “rape kit” forensic examinations used to collect evidence for law enforcement don’t cost the victim.

Nothing in state law designates who pays for the procedures, Louisiana Hospital Association President Paul Salles said, adding, “I don’t think it is clearly defined, and that may be where some of the confusion is coming from.”

“How do you manage the treatment part of the bill?” East Baton Rouge Parish Coroner Beau Clark said. “That’s what needs to be either legally answered or come up with some ideas to mitigate the cost of the treatment.”

Victims “are receiving $2,000 to $4,000 bills they should not be paying for,” state Rep. Helena Moreno said.

She and state Sen. J.P. Morrell, both New Orleans Democrats, are working to come up with a way to resolve the dilemma.

The problem is complicated and might need legislation or changes in administrative procedures and health care funding decisions.

For instance, Moreno said, the state Crime Victims Compensation Fund cannot be tapped for help unless the rape victim has reported the crime — and many victims don’t. “We have a little more research and homework to do,” Moreno said.

Olivia Watkins, a spokeswoman for the state Department of Health and Hospitals, said the agency will work with the Legislature and others so victims are provided needed services.

The current situation “is a result of disjointed local parish health policies, as well as inconsistent policies at hospitals across the state,” Watkins said. “We want victims to feel comfortable reporting, filing charges and seeking out care. We don’t want people avoiding the emergency room because they are afraid they cannot afford how much it will cost them.”

Ebony Tucker, executive director of the Louisiana Foundation Against Sexual Assault, said a statewide system is needed for handling the billing issues.

LSU’s private partner hospitals in New Orleans and Baton Rouge are among those that bill rape victims for medical services, but officials of each said there are assistance programs. Meanwhile, Woman’s Hospital in Baton Rouge, which is handling LSU’s obstetrics and gynecological services, does not charge.

Cindy Nuesslein, chief executive officer of the Interim LSU Hospital in New Orleans, said the administration researched state and federal guidelines on billing patients.

“Collecting of the forensic evidence — you don’t bill for that part, but you may bill for any contingent medical care, a broken arm, STD (sexually transmitted disease) testing,” Nuesslein said.

The hospital operates one of four Sexual Assault Nurse Examiner programs in the state with specially trained nurses on call around the clock to work with every rape victim.

“We follow up with them as long as it takes … through a trial,” said Dr. Jennifer Avegno, medical director of the program.

Nuesslein said the hospital works with the victims on medical bill payment, waiving insurance plan out-of-pocket expenses if they are unable to pay, helping them qualify for Medicaid, providing “substantial discounts” and getting them access to programs that offer financial aid. “The last thing we would want is for this to become another barrier for victims of sexual assault to getting care,” she said.

Baton Rouge’s Our Lady of the Lake Regional Medical Center has a similar policy, with victims of sexual assault billed for standard medical care “just as we do for people who need care because of other violent crimes and tragic events,” said Catherine Harrell, vice president for marketing and communication. She said the hospital provides financial support and resources based on individual need.

Woman’s Hospital in Baton Rouge does not ask sexual assault patients for any form of payment.

“In fact, the hospital has steps in place to ensure that these women are not billed. Additionally, Woman’s has a designated sexual assault exam room and a private consult room to provide women with much-needed privacy and support during this difficult time,” said Patricia Johnson, Woman’s senior vice president-chief nursing officer.

Follow Marsha Shuler on Twitter, @MarshaShulerCNB. For more coverage of the State Capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog.