Hospitals Get Paid More For Listing Patients As Having COVID-19

Fact Check: Hospitals Get Paid More For Listing Patients As Having COVID-19 Even If They Show Few Symptoms A Minnesota state senator, who also happens to be a doctor, has come forward to reveal how hospitals are getting more in funding if they list more patients as having COVID-19, even if the patients are more likely to have something else, such as pneumonia. The issue is the loose definitions of the terms “probable” and “presumed” and how those terms can be applied. This is less on the doctors themselves and more on the health care administrators.


Hospitals Get Paid More For Listing Patients As Having COVID-19
Even the leftist media is confirming this is true, as USA Today reports:
Sen. Scott Jensen, R-Minn., a physician in Minnesota, was interviewed by “The Ingraham Angle” host Laura Ingraham on April 8 on Fox News and claimed hospitals get paid more if Medicare patients are listed as having COVID-19 and get three times as much money if they need a ventilator.

On April 19, he doubled down on his assertion via video on his Facebook page.
Jensen said, “Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it’s straightforward, garden-variety pneumonia that a person is admitted to the hospital for – if they’re Medicare – typically, the diagnosis-related group lump sum payment would be $5,000. But if it’s COVID-19 pneumonia, then it’s $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000.”

Jensen clarified in the video that he doesn’t think physicians are “gaming the system” so much as other “players,” such as hospital administrators, who he said may pressure physicians to cite all diagnoses, including “probable” COVID-19, on discharge papers or death certificates to get the higher Medicare allocation allowed under the Coronavirus Aid, Relief and Economic Security Act. Past practice, Jensen said, did not include probabilities. As USA Today started looking into this, they found that even deranged leftist “fact-checkers” at Snopes agreed, saying “Snopes investigated the claim, finding it’s plausible Medicare pays in the range Jensen mentions but doesn’t have a “one-size-fits-all” payment to hospitals for COVID-19 patients.”

USA Today went on to cite FactCheck.org as also agreeing with the premise: Ask FactCheck weighed on April 21: “The figures cited by Jensen generally square with estimated Medicare payments for COVID-19 hospitalizations, based on average Medicare payments for patients with similar diagnoses.”
Ask FactCheck reporter Angelo Fichera, who interviewed Jensen, noted, “Jensen said he did not think that hospitals were intentionally misclassifying cases for financial reasons. But that’s how his comments have been widely interpreted and paraded on social media.”

In all, USA today ruled this as TRUE:
We rate the claim that hospitals get paid more if patients are listed as COVID-19 and on ventilators as TRUE.

Hospitals and doctors do get paid more for Medicare patients diagnosed with COVID-19 or if it’s considered presumed they have COVID-19 absent a laboratory-confirmed test, and three times more if the patients are placed on a ventilator to cover the cost of care and loss of business resulting from a shift in focus to treat COVID-19 cases. This higher allocation of funds has been made possible under the Coronavirus Aid, Relief and Economic Security Act through a Medicare 20% add-on to its regular payment for COVID-19 patients, as verified by USA TODAY through the American Hospital Association Special Bulletin on the topic.

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