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Hospital Payments and the COVID-19 Death Count - FactCheck.org

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Q: Are hospitals inflating the number of COVID-19 cases and deaths so they can be paid more?A: Recent legislation pays hospitals higher Medicare rates for COVID-19 patients and treatment, but there is no evidence of fraudulent reporting.FULL QUESTIONI keep seeing posts in social media claiming that hospitals are over-stating covid-19 deaths because the they are paid more for these deaths … The YouTube video link here is attributed to Fox News with the headline “US: Hospitals Get Paid More to List Patients as COVID-19…”FULL ANSWERA Minnesota state senator’s recent interview on Fox News about Medicare payments for COVID-19 hospitalizations has generated a frenzy of headlines on social media suggesting that hospitals may have a financial motivation when it comes to classifying cases or deaths as related to COVID-19.One ran a story headlined, “US Hospitals Getting Paid More to Label Cause of Death as ‘Coronavirus.'” It called the information “disturbing” and the&nbsp;interview “bone-chilling.”Numerous readers have asked us about such claims, some of which imply that hospitals are making money by simply listing patients as having the disease — when in fact the payments referenced are for treating patients.The initial comment was made byBut that’s how his comments have been widely interpreted and paraded on social media. One X22 Report [Geopolitical]” with a caption referencing the specific dollar amounts that read in part: “One of the meme, shared by hundreds, was captioned: “And then we wonder why the numbers of deaths are embellished…”The Centers for Medicare &amp; Medicaid Services has COVID-19 cases with for respiratory infections and inflammations. A CMS spokesperson told us exact payments vary, depending on a patient’s principal diagnosis and severity, as well as treatments and procedures. There are also geographic variations.An by the Kaiser Family Foundation looked at average Medicare payments for hospital admissions for the existing diagnosis-related groups and noted that the “average Medicare payment for respiratory infections and inflammations with major comorbidities or complications in 2017 … was $13,297. For more severe hospitalizations, we use the average Medicare payment for a respiratory system diagnosis with ventilator support for greater than 96 hours, which was $40,218.”It is true, however, that the government will pay more to hospitals for COVID-19 cases in two senses: By paying an additional 20% on top of traditional Medicare rates for COVID-19 patients during the public health emergency, and by reimbursing hospitals for treating the uninsured patients with the disease (at that enhanced Medicare rate).Both of those provisions stem from the , or CARES Act.The CARES Act the 20% add-on to be paid for Medicare patients with COVID-19. The act further created a that is being used to financially assist hospitals — a “portion” of which will be “used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured,” according to the U.S. Department of Health and Human Services.As the Kaiser analysis noted, though, “Either way, the fact that government programs are paying hospitals for treating patients who have COVID-19 isn’t on its own representative of anything nefarious.Hippocratic Oath, an institute fellow at the Urban Institute, said the notion that hospitals are profiting off the pandemic — as some of the social media posts may imply — isn’t borne out by facts, either.Berenson said revenues appear to be down for hospitals this quarter because many have suspended elective procedures, which are key to their revenue, forcing to cut staff. He surmised that potential instances of patients being wrongly “upcoded” — or classified as COVID-19 when they’re not — are “Berenson and others we spoke with also said that hospitals have profound disincentives for “upcoding,” which can result in , such as being susceptible to being kicked out of the Medicare program.Jensen himself said in a phone interview that he was not alleging widespread medical fraud.“Do I think people are misclassifying? No,” Jensen said. He said his concerns centered on what he deemed “less precise standards” for certifying deaths promulgated by the U.S. Centers for Disease Control and Prevention, and how deaths classified as COVID-19 without corroborating positive test results could lead to an over-counting.The CDC says that officials should report deaths in which the patient tested positive for COVID-19 — or, if a test isn’t available, “if the circumstances are compelling within a reasonable degree of certainty.” It further indicates that if a “definite diagnosis of COVID–19 cannot be made“If we think it’s presumptive … we can go ahead and put down COVID-19,” Jensen said, “or even in some situations, even if it’s negative.” He pointed to the of a 38-year-old man in Minnesota whose death was attributed to the coronavirus even though he tested negative.The man’s mother, however, told the St. Paul Pioneer Press that doctors determined the test result was likely a false negative. It’s not known exactly how common false negatives are in the U.S., but public health experts and doctors have about many instances of tests showing negative results even when all other indicators point to COVID-19.Fact sheets for different from the Food and Drug Administration note that a “negative result does not exclude the possibility of COVID-19. When diagnostic testing is negative, the possibility of a false negative result should be considered in the context of a patient’s recent exposures and the presence of clinical signs and symptoms consistent with COVID-19. The possibility of a false negative result should especially be considered if the patient’s recent exposures or clinical presentation indicate that COVID-19 is likely, and diagnostic tests for other causes of illness (e.g., other respiratory illness) are negative.”As for the accuracy of the death toll, other experts have previouslyWhen it comes to the $100 billion fund to help providers, future grants by HHS are to focus on providers in areas hit hard by the outbreak, among others. But theEditor’s Note: FactCheck.org does not accept advertising. We rely on grants and individual donations from people like you. Please consider a donation. Credit card donations may be made through&nbsp;. If you prefer to give by check, send to: FactCheck.org, Annenberg Public Policy Center, 202 S. 36th St., Philadelphia, PA 19104.&nbsp;SourcesBerenson, Robert. Institute Fellow, Urban Institute. Phone interview with FactCheck.org. 20 Apr 2020.“” U.S. Centers for Disease Control and Prevention. Accessed 20 Apr 2020.DePillis, Lydia and Caroline Chen. “.” ProPublica. 10 Apr 2020.Divine, Mary. “Hancock, Jay, et. al. “.” Kaiser Health News. 10 Apr 2020.Jensen, Scott. State senator, Minnesota. Phone interview with FactCheck.org. 20 Apr 2020.Levitt, Larry, et. al. “.” Kaiser Family Foundation. 7 Apr 2020.Medicare Payment Advisory Commission. “.” 11 Oct 2019.Schwartz, Karyn. Senior fellow, Kaiser Family Foundation. Phone interview with FactCheck.org. 16 Apr 2020.U.S. Centers for Medicare &amp; Medicaid Services. “.” Accessed 20 Apr 2020.U.S. Centers for Medicare &amp; Medicaid Services. “.” Accessed 20 Apr 2020.U.S. Department of Health and Human Services. “.” 16 Apr 2020.U.S. House. “” (as signed into law 27 Mar 2020)Ask FactCheckHave a question?

Q: Are hospitals inflating the number of COVID-19 cases and deaths so they can be paid more?A: Recent legislation pays hospitals higher Medicare rates for COVID-19 patients and treatment, but there is no evidence of fraudulent reporting.FULL QUESTIONI keep seeing posts in social media claiming that hospitals are over-stating covid-19 deaths because the they are paid more for these deaths … The YouTube video link here is attributed to Fox News with the headline “US: Hospitals Get Paid More to List Patients as COVID-19…”FULL ANSWERA Minnesota state senator’s recent interview on Fox News about...

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