Are hospitals falsely tagging patients with COVID-19 to make money?
Senior Medicare Patrol • July 8, 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.
The Area Agency on Aging of East Texas is partnering with First Christian Church in Jacksonville to offer a free Benefits & Estate Planning Presentation for Seniors and Caregivers. The informative workshop will be held Thursday, September 17, from 10 a.m. to noon at the First Christian Church Sanctuary, 1920 Beaumont Street in Jacksonville. Presented by Paul Zambie, Managing Attorney with Texas Legal Services Center, the session will help attendees better understand legal and planning issues that can affect older adults and their families. Topics will include wills and trusts, deeds, transfer-on-death deeds, long-term care Medicaid, Medicaid estate recovery, and senior services. This free presentation is designed to give seniors and caregivers practical information to help prepare for life’s challenges and make informed decisions about the future. For more information, contact the Area Agency on Aging of East Texas at 903-218-6500 or 1-800-442-8845.
This summer, ETCOG Director of Aging Programs Adrian Cornejo welcomed an extraordinary experience into his home through his volunteer work with Creating Friendships for Peace (CFP). For one month, Adrian hosted two students from Cyprus, Michael and Derin, who came to East Texas through the CFP program. During their stay, the students shared a room in Adrian’s home, experienced daily life in the region, shadowed Adrian at ETCOG, and attended an ETCOG Executive Committee meeting. Creating Friendships for Peace brings young people from communities affected by longstanding divisions together for cultural exchange, dialogue, and relationship-building. Cyprus has been divided for decades between Greek Cypriot and Turkish Cypriot communities, with a history of conflict and mistrust that can shape how young people see those from the other side of the island. Adrian said the experience gave him a deeply personal view of how division can affect young people and how meaningful it can be when they have the opportunity to connect outside of those divisions. “What I witnessed through these young men was difficult to process,” Adrian said. “Each of their societies has, in different ways, instilled distrust, division, and even hatred toward people on the ‘other side.’ Perhaps the most heartbreaking part is hearing that this begins when they are children.” Through his involvement with CFP, Adrian also hosted two young men from Israel for a few days, one Jewish Israeli and one Arab Israeli, who similarly came from communities shaped by complex social and political divisions. “This is not a political story,” Adrian said. “It is a personal reflection on what has been one of the most emotional and humbling experiences of my life. Hearing the students’ experiences made me realize just how much we take for granted here in the United States,” he said. “We have the freedom to think, to question, and to decide for ourselves what we believe and how we treat others.” For Michael and Derin, their time in East Texas offered an opportunity to see a different community, to witness regional collaboration in action as our elected officials voted on ETCOG business, and to build friendships beyond the boundaries and assumptions they may encounter at home. “I think words are too little to describe the last four weeks,” said Michael. “This month we became a family. I was talking with Derin, and I told him it feels like we are packing to go to vacation, not home.” “I want to thank Mr. Adrian for hosting us and being part of our destiny in this trip,” said Darin. “You are very hard working and care about us. I am very grateful for you taking us to San Antonio trip, for your work, and giving us opportunities to meet wonderful people…I wish to mature up and become a person like you one day wh helps everyone like you do.” Adrian said the friendships formed through CFP demonstrate that meaningful change often starts on a personal level. “Peace doesn’t begin with governments or political agreements,” Adrian said. “Sometimes, it begins with a conversation, a friendship, and the willingness to see another person as a human being rather than as a representative of ‘the other side.’” He added that he is grateful for the friendships and perspectives the students brought into his life. “I will carry their stories, their friendship, and what I learned from them with me for a very long time,” Adrian said. ETCOG is proud to recognize Adrian’s commitment to service and his willingness to share both his home and workplace with students participating in this important exchange for peace.
