Fact Check: Yes, Hospitals Get Paid More If Patients Listed As COVID-19, On Ventilators

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A Minnesota physician spoke with “The Ingraham Angle” host Laura Ingraham during an interview and claimed that hospitals get paid more in Medicare patients are listed as having COVID-19, according to USA Today.

Scott Jensen appeared on the interview on April 8 on Fox News and also claimed that hospitals get paid three times as much if Medicare patients need a ventilator.

The claim was published on April 9 by The Spectator. WorldNetDaily shared it on April 10.

Jensen took to Facebook on April 15, saying, “How can anyone not believe that increasing the number of COVID-19 deaths may create an avenue for states to receive a larger portion of federal dollars. Already some states are complaining that they are not getting enough of the CARES Act dollars because they are having significantly more proportional COVID-19 deaths.”

“Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it’s a 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.”

More from USA Today:

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.

He noted that some states, including his home state of Minnesota, as well as California, list only laboratory-confirmed COVID-19 diagnoses. Others, specifically New York, list all presumed cases, which is allowed under guidelines from the Centers for Disease Control and Prevention as of mid-April and which will result in a larger payout.

Jensen said he thinks the overall number of COVID-19 cases have been undercounted based on limitations in the number of tests available.