Exam Payment Research



The US Government Accountability Office (GAO) 2024 report on states’ and territories’ coverage for medical forensic exams and related medical treatments. (published- 6/18/2024)

Report: “Sexual Assault: States Provide for Survivors to Access Free Forensic Exams but Total Costs are Unknown” (GAO-24-106036)

Centers for Disease Control and Prevention: Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States (updated – January, 2021)


Urban Institute: Examining the Implementation of the SAFE Protocol – payment practices for sexual assault medical forensic exams



The Monetary Cost of Sexual Assault to Privately Insured US Women in 2013 American Journal of Public Health, 2017. Tennessee, A., Bradham, T., White, B., Simpson, K.
Key findings from this study:

  • The analysis studied insurance provider payment for 1355 incidents for adult (16-61 years) female victims
  • Victims remit on average 14% of the cost of the “rape cost”
  • That 14% amounts to $948 of the “rape cost”
  • Insurance providers pay 86% or $5789 of the total cost



Sexual Assault Medical Forensic Exams and VAWA 2005: Payment practices, successes, and directions for the future. Urban Institute, 2014. Zweig, J. Newmark, L., Raja, D., Denver, M.

Key findings from this study:

  • Victims compensation funds are by far the largest designated source of funds to pay for sexual assault medical forensic exams across the U.S., but sufficient funds are a major concern.
  • Most victims are able to receive free exams without having to report to law enforcement with very few exceptions
  • Barriers to even accessing the exam are real- and prevent some victims from seeking help; this is especially true for individuals identifying as non-English speakers, immigrants or American Indians
  • Among the few victims who get exams but do not report at the time of the exam, few file an official report at a later date.