Blog Post
Are hospitals falsely tagging patients with COVID-19 to make money?
Senior Medicare Patrol • Jul 08, 2020
Senior Medicare Patrol Investigates
You’ve probably seen the headlines making the social media rounds. Claims that “hospitals get paid more to treat COVID-19 patients” and “is medicare paying hospitals $13,000 for patients diagnosed with COVID-19 and $39,000 for those on ventilators?”
In a recent post to the KPRC 2 Facebook page, a woman claimed discharge papers showed her mom had COVID-19 when she “absolutely did not have it,” and her husband told her hospitals get $30,000 per patient.
She’s not alone in asking Channel 2 Investigates about this, so we decided to put two claims through our Trust Index.
Is Medicare paying hospitals more for COVID-19 patients?
Here’s how Medicare, which is funded through your tax dollars, works.
When patients are discharged, hospitals assign them a code on their diagnosis and treatment, and Medicare pays hospitals a set amount based on that code. But when Congress drew up the CARES Act, it created a 20% “add on” for treatment of COVID-19 patients.
“The key component of it was an additional reimbursement for patients who had COVID to offset the revenue the would’ve made for their typical procedures,” explained hospital billing expert Shawn Fry. “Depending on the severity of the patient, you could make double, or even four or five times as much on that COVID patient.”
Politifact looked at an analysis by the Kaiser Family Foundation which found the average Medicare payment for a less severe COVID-19 hospitalization was just over $13,000, and for a hospitalization requiring a ventilator it was just over $40,000. This includes the 20% “add on” through the CARES Act. That increases the hospital’s standard payment for similar treatment of non-COVID patients.
We rate the claim that hospitals make more money from COVID-19 patients as true.
Are hospitals falsely tagging patients with COVID-19 to make money?
“It is a possibility, any time you’re dealing with billing and coding,, there is a possibility for error,” said Jennifer Salazar with the Better Business Bureau’s Texas Senior Medicare Patrol. She advises that patients be proactive in tracking their diagnoses and treatments.
“When you got to the hospital or you see your doctor, write it down, write down what you’ve had done,” Salazar said.
And always review your discharge papers.
“If you see anything that looks suspicious or incorrect, if your not sure about, call us at the Texas Senior Medicare Patrol,” she said.
But there’s no hard evidence that hospitals are fraudulently identifying patients as “COVID positive”.
“To my knowledge, and I’ve talked to several different hospitals, no doctor has ever been incentivized to add the COVID-19 diagnosis to any patient’s file,” Fry said.
There are protocols in place to prevent that, including frequent audits, and harsh penalties for those who are caught doing it.
We rate the claim that hospitals are falsely tagging patients with COVID-19 to make money as false.
“Power in Community” Conference Will Cover Medicare Basics, Savings Programs, Preventing Fraud, Health and Wellness, and Community Resources
Throughout May, the Area Agency on Aging of East Texas (AAA) is joining organizations across the nation to celebrate the seniors in our communities for Older Americans Month (OAM). The AAA will host and partner with organizations for six celebration events across East Texas at area senior centers and community centers focusing on connection – how communities can build relationships to maintain a healthy senior population. OAM is a national initiative led by the Administration for Community Living. This year’s theme, Powered by Connection , recognizes the profound impact that meaningful relationships and social connections have on our health and well-being. The following OAM celebration events are open to the public and will include food, fun, door prizes, and information on services available to East Texas seniors: May 8th at the Forever Young Activity Center, located at 404 S. Main St. in Quitman, from 10:00 AM - 1:00 PM May 9th at the Harrison County Extension Office, located at 2005 Warren Dr. in Marshall, from 9:00 AM - 12:00 PM May 14th at the Douglas Alumni Association Inc., located at 408 Terry St. in Pittsburg, from 9:30 AM - 2:00 PM May 16th at the First United Methodist Church, located at 225 Lovers Ln in Athens, from 9:30 AM - 2:00 PM May 30th at Central Baptist Church, located at 220 W. Sabine St. in Carthage, from 9:30 AM - 1:00 PM The AAA serves as the region's leader in advocating and providing various services, such as information and referral, benefits counseling, case management, health education classes, senior nutrition, housing repair, and support through the Ombudsman program for people in nursing and assisted living facilities. These services help older individuals live independent, meaningful, and dignified lives in their own homes and communities for as long as possible. Contact the AAA for questions about the events by calling (903) 218-6500.
About Us
The Area Agency on Aging of East Texas
is designated by the Texas Health and Human Services Commission (HHSC) to coordinate services for persons in East Texas who are 60 or older, with particular attention to low-income minority older individuals, older individuals with limited-English proficiency, and older individuals residing in rural areas.
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