JEFFERSON CITY — Missouri hospitals are charging the state as much as $1,500 to process rape kits, a cost that led some lawmakers to suggest Wednesday the state needs to cap its reimbursement rates.
Figures provided by the Missouri Department of Public Safety show the state paid about $2 million in reimbursements for 2,771 rape test kits in the 2010 fiscal year, an average of about $753 each. But those costs have varied widely in recent years — from as little as $29.50 per test at one Cape Girardeau hospital in the 2009 fiscal year to as much as $1,568 per test at a St. Louis hospital this year.
Members of the Budget Committee of the Missouri House of Representatives expressed concern Wednesday that the state might be getting overcharged.
"I don't want this program to go away, but I don't want us to be wasting money either," said Rep. Marsha Haefner, R-St. Louis.
Tom Orf, the department's budget officer, said there is no limit on the rate hospitals can charge.
Rep. Chris Kelly, D-Columbia, said the department should have a plan for setting a rate cap before Tuesday, when the committee is to consider the department's budget again.
Susan Sudduth, the program director for the state's crime victims' compensation fund, said the Department of Public Safety is working with the Missouri Hospital Association to set a cap on rape kit reimbursement rates.
One reason the charges might vary so much, Orf said, is that the state is the "payer of first resort" for the costs of a sexual assault victim's treatment. That means the hospital sends the bill to the state first and the state pays all costs related to administration of the rape test kit. Then, the victim's insurance company or Medicaid pays for other costs unrelated to administration of the kit.
But some hospitals' reimbursement requests might be higher than the cost of a kit because they are including in their total the cost of a doctor administering the kit — or even the entire cost of the emergency room visit.
Sudduth said the department thinks state laws governing the fund require it to pay for those treatment costs that are related to the administration of the kit.
But the hospitals get to decide the price of those services, without any limitation from the state about what it will pay.
Rep. Dave Schatz, R-Sullivan, said the state is paying the hospitals' charges unquestioningly, without looking to see whether those prices are justified.
"Either someone understands how to work the system or something's going on here," Schatz said. "Obviously no one is really looking at the funds. When you receive a doctor's bill, you look to see that the treatment you received is the treatment you got."