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.
Each May, the Administration for Community Living leads the nation’s observance of Older Americans Month, and this year’s theme was “Champion Your Health.” In recognition of the month, the Area Agency on Aging of East Texas hosted three community events in Jacksonville, Marshall, and Athens, bringing together older adults, caregivers, staff, volunteers, and community partners to celebrate healthy aging and support older adults’ independence. More than 420 people attended the three events, where they received information and heard from experts on senior services, exercise programs, fraud and scams, and ways to take an active role in managing their health. Activities included on-site health screenings, evidence-based activity demonstrations, a Dementia Live demonstration, and the TxDOT Car Fit Program for Seniors. At some events, local officials also read proclamations recognizing May as Older Americans Month, including Cherokee County Judge Chris Davis, who presented the proclamation in Jacksonville. “We encourage older East Texans and their caregivers to connect with our agency to learn more about the resources and services available to help them live independently and remain active in their communities,” said Adrian Cornejo, ETCOG’s Director of the Area Agency on Aging. Special thanks to all event partners, sponsors, volunteers, AAA staff, and participants who helped make these Older Americans Month events a success!
Throughout May, the Area Agency on Aging of East Texas (AAA) will join organizations across the nation in celebrating Older Americans Month (OAM), led by the Administration for Community Living, honoring the important contributions of older adults in our communities. This year’s theme, “Champion Your Health,” encourages older adults to focus on the steps they can take to support their physical, mental, and emotional well-being, while highlighting the resources and community connections that help people age well. In recognition of Older Americans Month, AAA will host three special events at community locations across East Texas to celebrate older adults and share information about programs and services available to seniors and caregivers. Throughout the month of May, the Area Agency on Aging will also participate in additional events that promote the mental and physical health of our communities and recognize the many contributions older Americans have made, and continue to make, across the country. As the United States marks its 250th anniversary this year, Older Americans Month also offers an opportunity to reflect on the generations of older adults whose service, leadership, and life experiences have helped shape our nation, our state, and our local communities. “Older Americans Month is an important time to recognize the lasting contributions of older adults and the many ways they strengthen our communities,” said Adrian Cornejo, ETCOG’s Director of the Area Agency on Aging. “This year’s theme, Champion Your Health, reminds us of the importance of supporting healthy aging by connecting older East Texans with resources, services, and opportunities that help them live well and remain engaged.” The following OAM celebration events are free and open to the public and will feature information on services and supports available to East Texas seniors: Friday, May 15 10:00 AM – 2:00 PM First Christian Church 1920 Beaumont St. Jacksonville, Texas 75766 Wednesday, May 20 9:00 AM – 12:00 PM Marshall Convention Center 2501 E. End Blvd S. Marshall, Texas 75672 Thursday, May 21 10:00 AM – 4:00 PM First Methodist Church of Athens 225 Lovers Lane Athens, Texas 75751 The AAA is the region’s leader in advocacy and services for older adults, providing support such as information and referral, benefits counseling, case management, health education classes, senior nutrition, and the Ombudsman program for people living in nursing and assisted living facilities. These services help older individuals live independent, meaningful, and dignified lives in their homes and communities for as long as possible. For questions about the events, contact the Area Agency on Aging of East Texas at (903) 218-6500.
