Since the start of the coronavirus pandemic in 2020, claims have been circulating on social media and other websites suggesting that hospitals across the country are receiving additional funding for listing COVID-19 as a patient’s cause of death. The claims have been circulating as early as April 2020, when former Minnesota Sen. Scott Jensen appeared on Fox News claiming doctors were being encouraged to overcount coronavirus deaths in an effort to get more money.
VERIFY viewer Jean and several others recently emailed us asking if these claims are true.
Do hospitals get more money when they list COVID-19 as a patient’s cause of death?
No, hospitals do not get more money when they list COVID-19 as a patient’s cause of death.
WHAT WE FOUND
Hospitals and health systems are eligible to receive higher Medicare payments for complex COVID-19-related treatment under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including a Medicare add-on payment of 20% for both rural and urban inpatient hospital COVID-19 patients, according to the American Hospital Association (AHA). The CARES Act was signed into law by former President Donald Trump on March 27, 2020.
While hospitals can receive additional funding to treat certain COVID-19 patients, an AHA spokesperson told VERIFY in a statement “that hospitals and health systems do not get paid based on a statement of the cause of death, regardless of what it is.”
“They do get a bump in payment from Medicare if a patient has a diagnosis of COVID-19 listed on the bill,” the AHA spokesperson explained. “This is meant to recognize the additional costs associated with caring for COVID positive patients – costs such as additional PPE to protect staff and prevent spread, additional costs in cleaning and taking special precautions with all devices and materials moving in and out of the patient’s room, and additional costs in caring for the patient (such as therapeutics).”
A Centers for Medicare & Medicaid Services (CMS) spokesperson confirmed that hospitals generally receive additional payments to treat Medicare patients diagnosed with COVID-19, but the payments are not tied to the patient’s cause of death.
“The additional payment is not tied to whether or not the patient expires in the hospital, or the cause of death if the patient does expire in the hospital,” the CMS spokesperson told VERIFY in a statement.
A Kaiser Family Foundation (KFF) spokesperson also confirmed that Medicare provides a bump in payment for COVID-related treatment, but told VERIFY the additional payment is unrelated to whether a COVID-19 positive patient died at the hospital. The spokesperson also debunked claims that hospitals are trying to game the system to get more money.
“There’s no evidence of hospitals gaming the system to boost payments inappropriately,” the KFF spokesperson said. “There needs to be a documentation of a positive lab test for COVID-19 in the patient’s medical record in order to qualify for the 20% payment bump. If they did falsify records to get a pay bump, that would be fraud.”
“Hospitals do not receive extra funds when patients die from COVID-19. They are not over-reporting COVID-19 cases. And, they are not making money on treating COVID-19,” Pollack wrote. “Hospitals and health systems adhere to strict coding guidelines, and use of the COVID-19 code for Medicare claims is reserved for confirmed cases. Coding inappropriately can result in criminal penalties and exclusion from the Medicare program altogether.”