NEW YORK >> The victims came to New York hospitals after being sexually assaulted. Then, against state law, they were billed for their own rape evidence kits. In some cases, they were hounded by bill collectors.

A yearlong investigation by state Attorney General Barbara Underwood found that seven hospitals in New York had illegally billed more than 200 sexual assault survivors for rape kits, with individual charges ranging from $46 to $2,892. Underwood said today that her office had reached civil settlements with the hospitals, which agreed to refund patients and to implement formal policies to ensure that it would not happen again.

“Survivors of sexual assault have already gone through unfathomable trauma,” Underwood said in a statement. “To then subject them to illegal bills and collection calls is unconscionable.”

The investigation started last November when advocates for sexual assault victims told the attorney general’s office about a woman who had been billed seven times for her rape kit, first by Brooklyn Hospital Center then by debt collectors. That case led to a wider inquiry.

“We were stunned that they found as many cases as they did,” said Mary Haviland, the executive director of the New York City Alliance Against Sexual Assault, which brought the Brooklyn case to the attorney general’s attention.

The hospitals that reached settlements included both large and small institutions. Among them were NewYork-Presbyterian/Columbia University Medical Center, Richmond University Medical Center, Brookdale University Hospital and Medical Center and St. Barnabas Hospital.

Since 2005, a state law has required hospitals to provide services to sexual assault victims free of charge. The hospitals are supposed to bill the state Office of Victim Services for rape kits, unless victims choose to have the hospital bill their insurers.

But the attorney general’s office found the hospitals were not only billing some patients for collecting evidence, but then sometimes were billing their insurers as well. Some of the unpaid bills were even handed over to debt-collection agencies.

For instance, Richmond University Medical Center in Staten Island billed 28 patients for rape kits between January 2016 and Nov. 27, 2017, and in 10 cases also billed their insurers, settlement documents showed.

The emergency room physicians group separately billed 13 patients, and in two cases, double-dipped by also billing the insurer. Four of those patients were dunned by collection agencies.

“It’s like dredging up the entirety of the trauma that brought them to the hospital in the first place, where, by law, they have the right to get a free exam,” said Christopher E. Bromson, the executive director of the Crime Victims Treatment Center in Manhattan.

A spokesman for Richmond University Medical Center said that in response to the settlement the hospital “has assessed its internal policies and protocols to ensure they are in full compliance with the law.”

Court papers showed that 24 patients at NewYork-Presbyterian/Columbia hospital were illegally billed by Columbia University over the same period, and 19 of those bills were eventually sent to collection agents. A spokesman for the university said the bills were sent in error.

“Hospital billing departments are such behemoths that without constant monitoring, this can happen,” Bromson said.

Steven Clark, a spokesman for St. Barnabas Hospital in the Bronx, apologized that invoices for rape kits were sent to eight patients during the 23-month period in question.

“While the hospital never pursued payment from these patients, we acknowledge that the billing was done in error,” he said. “We have since instituted a training program among our clinicians to make sure all policies and procedures are followed and this does not happen again.”