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VERIFY: Hospitals get paid more if patients listed as COVID-19

The federal government is paying hospitals more for treating COVID-19 Medicare patients. However, there is no indication that hospitals are over-reporting cases.

MAINE, USA — It's a claim that's being spread widely online: Hospitals get paid more by the federal government if patients list as having COVID-19 or are on ventilators. NEWS CENTER Maine set out to "Verify."

This claim specifically applies to Medicare patients.

Medicare pays for inpatient hospital stays based on the patient's primary diagnosis. How it works is the hospital assigns a code to a patient at the time of discharge, based mainly on the patient's main diagnosis and treatment given. Medicare then pays the hospital a prescribed amount of money.

Under the CARES Act, hospitals can add 20% to their fee for treating a COVID-19 patient on Medicare.

According to an analysis by the Kaiser Family Foundation, the average medicare payment for a COVID-19 patient is around $13,000. If a patient is on a ventilator for at least four days, Medicare may pay out around $40,000.

In short: 

Yes, hospitals are making more for treating someone with COVID-19, then let's say, someone with pneumonia.

However, there's no evidence to show hospitals are over-reporting the number of COVID-19 patients.

A closer look: 

President of the Maine Hospital Association Steven Michaud says there's a good reason the federal government is paying out more for hospitals to care for COVID-19 patients. 

"The resources to take care of COVID patients are enormous," says Michaud. "Their length of stay is double, at least, the average of the normal length of stay. They tend to be in ICUs where the cost is incredible for the drugs, and more important, PPE that you use to take care of them. So yeah, it's the opposite of a financial winner, let's just be clear about that."

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Furthermore, hospitals have lost their biggest revenue generator in losing the ability to perform elective procedures. Elective procedures in Maine have been postponed because of the COVID-19 pandemic. 

Michaud says it's very unlikely that physicians or hospitals would be falsifying data because there are severe repercussions for doing so and they would likely get caught. 

"The federal program Medicare audits all of that stuff and if there was any change or something like a change in coding, they would audit all of that. So there is no risk really of that happening."

At NEWS CENTER Maine, we're focusing our news coverage on the facts and not the fear around the illness. To see our full coverage, visit our coronavirus section, here: /coronavirus

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