Are hospitals 'gaming the system' on COVID cases?

Friday, May 1, 2020
 | 
Chris Woodward (OneNewsNow.com)

ventilator patientA major national newspaper is reporting that hospitals and doctors get paid more if Medicare patients are listed as COVID-19 and on ventilators. OneNewsNow spoke with a scholar who says there's no reason to doubt that that arrangement is being abused.

The finding from USA Today comes in a fact check following recent comments from physician and State Sen. Scott Jensen (R-Minnesota) on Fox News Channel's "The Ingraham Angle" program. Jensen said hospitals get paid more if Medicare patients are listed as having COVID-19, and three times more if those patients need a ventilator.

"There's no reason to doubt this information at all," says Merrill Matthews, Ph.D. of the Texas-based Institute for Policy Innovation. "The question that arises then is: Are hospitals and/or doctors somehow … gaming the system in order to bring more money in?"

Many large hospitals today are struggling financially.

Matthews

"Several hospital systems are laying people off because the governors essentially shut down elective surgeries and other things that the hospitals do and make money off of – so a number of hospitals are struggling and many of them don't even have COVID-19 cases," Matthews continues.

According to Matthews "there has been a history of hospitals working with their states to game the Medicaid system in order to be able to get more money."

"That's because the federal government pays the states and the hospitals what's called a 'matching grant' for the money that states and hospitals spend on patients," he adds.

Meanwhile, it is well documented that people in general dying with COVID-19 are being counted as having died from COVID-19. Dr. Deborah Birx said as much at a coronavirus task force briefing on Tuesday, April 7.

Based on that, Matthews thinks people are "absolutely justified in being a little bit skeptical" of the number of COVID-19 patients and fatalities.

"Part of this is just the definition," explains Matthews. "There is no standard definition in the country about what a COVID-19 death is, as different states, different hospitals, and different doctors all have different standards by how you determine what's a COVID-19 death. And we've had a number of doctors who have stepped up and said they've been pressured a little bit [that] if there's any way possible to call it a COVID-19 death, to do that."

Matthews adds that hospital departments or epidemiologists that have been claiming they need to have more beds and more money because there could be hundreds of thousands of deaths "don't look as good if the death rates doesn't come up to nearly what you are saying."

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