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.
USAging is celebrating 50 years as the national organization that represents Area Agencies on Aging (AAAs) and Title VI Native American Aging Programs. As part of the 50th anniversary, USAging has launched a new public awareness campaign— Area Agencies on Aging: Helping You Live Long and Stay Strong . The goal of this campaign is to make the public aware of AAAs as a vital community resource and to educate consumers about the range of important services that AAAs offer to older adults, people with disabilities and caregivers. There are more than 600 AAAs serving every community across the country ready to help them to age well where most want—at home and in their community. All people hope to enjoy a long and healthy life—but many find that they need a little help as they go through the aging journey. “Research has shown that two-thirds of older adults will need some support to age well at home,” said USAging CEO Sandy Markwood. “But people often don’t know about AAA services or seek them out until they are in crisis—thereby missing the opportunity to connect to the range of services that are available to help them age well.” Services Provided by AAAs For Older Adults: Home-delivered and congregate meals: Nutritious meals at home or in group settings. In-home support: Assistance with daily tasks like bathing, cleaning and dressing. Transportation: Rides to medical appointments, stores and community activities. Health and wellness programs: Fall prevention, chronic disease management fitness classes. Benefits counseling: Help understanding and enrolling in Medicare, Medicaid and more. For Caregivers: Respite care: Short-term relief to prevent burnout. Training and support: Educational tools and support groups for caregivers. Information and referral : Guidance to local programs, services and community resources. “By 2035, older adults are expected to outnumber children under age 18 for the first time in the history of this country,” said Markwood. “By 2040, a full 22 percent of the American population will be 65 years or older. Currently, there are more than 53 million unpaid family caregivers in the United States. There has never been a more crucial time for people to learn about AAAs and the services that are available to them to help them live long and stay strong.” For more information, visit www.usaging.org/livelongstaystrong or connect with your local AAA by contacting the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov .
Throughout May, the Area Agency on Aging of East Texas (AAA) will join organizations nationwide in celebrating Older Americans Month (OAM). This month-long observance honors the contributions of seniors in our communities. To mark the occasion, AAA will host and collaborate with local organizations for four special celebration events across East Texas, held at senior centers and community hubs. These events will highlight the importance of connection and the role strong relationships play in maintaining a vibrant, healthy senior population. OAM is a national initiative led by the Administration for Community Living. This year’s theme, “Flip the Script on Aging,” challenges outdated perceptions and encourages a fresh perspective on aging. It promotes a shift in how society talks about, understands, and supports older adults, empowering communities to embrace aging in a more positive and inclusive way. Join Us for These Community Celebrations! The following OAM events are open to the public and will feature food, entertainment, door prizes, and valuable information about services available to East Texas seniors: 📅 May 7 – Henderson Community Building, 302 Fair Park, Henderson | 10:00 AM - 1:00 PM 📅 May 15 – First United Methodist Church, 225 Lovers Ln, Athens | 9:30 AM - 2:00 PM 📅 May 16 – Jefferson Senior Center, 111 W. Broadway, Jefferson | 9:00 AM - 12:30 PM 📅 May 21 – Harrison County Agrilife Extension Office, 2005 Warren Drive, Marshall | 9:00 AM - 12:00 PM The AAA advocates for seniors and provides essential services, including benefits counseling, case management, health education, nutrition programs, referrals, and Ombudsman support for those in assisted living. These services promote independence and dignity, helping seniors remain in their communities. For event inquiries, call (903) 218-6500.
