Coronavirus COVID-19 - Global Health Pandemic #76

[Simply Southern]

Here’s a quickie about that says they in fact do get extra supplements from the government for Covid treatments. This isn’t a rumor since you don’t believe me. If you think the medical field is a squeaky clean bunch you’re wrong.
Do hospitals get more funding by marking deaths COVID-19 related? | abc10.com

“According to the US Department of Health and Human Services [HHS] which oversees the Centers for Medicare & Medicaid Services, under the federal coronavirus aid relief bill known as the CARES Act, hospitals get an extra 20% in Medicare reimbursements on top of traditional rates due to the public health emergency.

That's for COVID-19 related admissions, which can include deaths. The pay-out amount varies, according to a medicare spokesperson who said "medicare adjusts hospital payment based on geographic variation in local costs."

Also, earlier this month, HHS announced a second round of federal relief for hospitals in high impact areas, totaling $10 billion.

Of that second-round money, HHS reported 63 California hospitals received $50,000 for each eligible coronavirus patient they admitted between Jan. 1 and June 10, 2020. That's a combined total of more than $607 million.“

CMS is initially paying at a higher rate based in hospital Covid diagnosis. All hospital Covid and pneumonia claims are under medical review. Hospital medical case managers are involved from admission, tracking and documentimg to insure the medical record clearly support Covid diagnosis, labs, testing, xrays, appropriate medications, and protocols are followed.

It not unusually for insurance or Medicare case managers to request documentation during an admission.

Using a false diagnosis to bill Medicare is a Federal crime, resulting in prison time, and hefty fines, and suspension from any future participation in the Medicare/Medicaid program. Disbarment from any city, state or federal program.

Don't see many hospitals, doctors, or nurses willing to risk a few thousand dollars, knowing the claim will be reviewed and all involved would have their licenses revoked, jail time and financial ruin.

JMHO...

 

[ilovewings]

This is sad on so many levels. It's a great grief to know that so many people have died, and a great many more will live with health issues and financial strain.

It's sad that during this pandemic, the American people aren't able to trust their medical system. Some people will brush off these deaths as clerical fraud.

It's sad that the pandemic in the US has exposed deep political divisions that undermine a national effort to eradicate the virus.

It's sad that 178,000 deaths are not enough to unite the people to action.

Hi Musical: I love your thoughtful post- you are so right and so insightful- it is like 178,000 deaths (and counting) is not enough for people to understand the seriousness of this hideous virus. It is not enough deaths I guess-----unless of course it is someone's mother, father, sister, brother, wife, etc. What is even more astounding, is that it isn't just deaths that are horrible, think of the 5 million people who have been brought down by this virus; many of them will never be the same again: they will have permanent residual complications - some will have temporary residual complications like loss of smell and taste: many of those people have not gotten their sense of taste and smell back. The horror is how this virus is being politicized- it is a crime in and of itself. It isn't just old people either but people like to think it is just old people who get this virus. Lots of younger people have fallen ill and are shocked because they thought they were immune from it.

 

[ilovewings]

CMS is initially paying at a higher rate based in hospital Covid diagnosis. All hospital Covid and pneumonia claims are under medical review. Hospital medical case managers are involved from admission, tracking and documentimg to insure the medical record clearly support Covid diagnosis, labs, testing, xrays, appropriate medications, and protocols are followed.

It not unusually for insurance or Medicare case managers to request documentation during an admission.

Using a false diagnosis to bill Medicare is a Federal crime, resulting in prison time, and hefty fines, and suspension from any future participation in the Medicare/Medicaid program. Disbarment from any city, state or federal program.

Don't see many hospitals, doctors, or nurses willing to risk a few thousand dollars, knowing the claim will be reviewed and all involved would have their licenses revoked, jail time and financial ruin.

JMHO...

I have a question: During Covid there were all these patients on vents- hospitals were bulging with patients- yet, some hospitals, for example Beaumont Hospital here in the Detroit area had to lay off a lot of staff because they were losing money: you may ask why were they losing money? because hospitals and docs make money on elective procedures which were not occurring at the height of the pandemic. I was surprised at that myself because i thought hospitals were making lots of money on patients who were on vents.

 

[SouthAussie]

I have a question: During Covid there were all these patients on vents- hospitals were bulging with patients- yet, some hospitals, for example Beaumont Hospital here in the Detroit area had to lay off a lot of staff because they were losing money: you may ask why were they losing money? because hospitals, and docs make money on elective procedures which were not occurring at the height of the pandemic. I was surprised at that myself because i thought hospitals were making lots of money on patients who were on vents.

Apparently the payments are 'grouped'. So, I don't think the money is per patient, it is per group of patients (who knows how large a group is?) And I think it is per group of Medicare patients. Which wouldn't include every patient in these categories?

I have seen it reported that Medicare provides $5,000 per group of pneumonia Medicare patients, $13,000 per group of covid Medicare patients, and $39,000 per group of covid Medicare patients on ventilators.

These higher payments are made for the extra staff and equipment required for the care of these types of Medicare patients.

That is my understanding of it, anyway.

Here’s What Is Wrong With The ‘I Don’t Trust The COVID-19 Death Count’ Argument

 

[mickey2942]

CMS is initially paying at a higher rate based in hospital Covid diagnosis. All hospital Covid and pneumonia claims are under medical review. Hospital medical case managers are involved from admission, tracking and documentimg to insure the medical record clearly support Covid diagnosis, labs, testing, xrays, appropriate medications, and protocols are followed.

It not unusually for insurance or Medicare case managers to request documentation during an admission.

Using a false diagnosis to bill Medicare is a Federal crime, resulting in prison time, and hefty fines, and suspension from any future participation in the Medicare/Medicaid program. Disbarment from any city, state or federal program.

Don't see many hospitals, doctors, or nurses willing to risk a few thousand dollars, knowing the claim will be reviewed and all involved would have their licenses revoked, jail time and financial ruin.

JMHO...

You would be amazed. Have you ever looked at Medicare fraud? I can't believe the number of professionals who put their licenses at risk for money.

Greed.

 

[10ofRods]

Death rates aren’t accurate either. You hear about the nursing home fraud and think it can’t be. My best friends mom died. They asked if they could mark her as Covid because they got a certain amount of money if it was. So if that happened to his mother, how many others has it happened to? There are so many red flags with covid. An illness that by the way has a 98.5% survival rate.

Department of Justice Requesting Data From Governors of States that Issued COVID-19 Orders that May Have Resulted in Deaths of Elderly Nursing Home Residents

Please post a citation for that survival rate. Worldometers says 5% of those who have gotten it have died - and in some US States it appears to be 6%.

Where did you get the 1.5% rate? That's approximately the rate for people aged 55-70.

Not all people. People who are older have higher rates (and therefore bump that average up).

 

[Simply Southern]

You would be amazed. Have you ever looked at Medicare fraud? I can't believe the number of professionals who put their licenses at risk for money.

Greed.

I worked for a large corporation that became involved with a 9 BILLION dollar qui tam, whistleblower suit from a company we purchased. Yes, it was clear the company we purchased was guilty after auditing just a small sampling of claims. During due diligence, we reviewed all financial information but did not have access to the patient files.

We settled for 400 million, had to audit every claim this company billed and fully cooperated with federal agents. It was a nightmare that lasted 5 years. Our stock went from splitting, to $1.00 per share.

Yeap, Federal Marshall showed up with warrants, in bullet proof vest and guns in their holsters. All employees had to leave the building with pocketbooks only. They pad lock the doors, make copies of all records and gave us the copies. We had to work from another location for 2 years, while the buildings were seized.

Thanks to the whistleblower, the feds knew exactly which locations to go to. They hit and seized 8 locations in 4 days. The whistleblower received 25% of the 400 million settlement for cooperating and supplying detailed information.

That's why I am so meticulous about all federal, state and local, guidelines and laws. As a "fixer", working on this mess, I was told early on... to hide nothing, do not lie, fully cooperate, be prepared to take a lie detector test at any time the government requested and to seek private council before accepting this new job assignment. Every document I generated or received was labeled client-attorney privilege" the entire process.

It happens folks get greedy, think they can beat the system and most of all don't have a check and balance business structure. Its usually smaller medial practices and providers.

We may see some fraud with Covid, but CMS recoups money quickly from all hospitals with constant claims review. CMS is all over Covid, monitoring claims, deaths by diagnosis, mandating nursing homes test patients, and starting the legal process with some states to obtain death information. CMS is a powerful government agency.

JMHO...

 

[weepingangel]

Jmo re Medicaid fraud but most of the cases I’ve seen locally are small medical offices vs large hospitals. Guessing it’s easier when there’s fewer people involved / less oversight?
*******


Our Local hospitals are doing just fine financially imo. ( first one furloughed employees /second didn’t )
I realize that will not be the case everywhere

more at both links

MA Hospital Giant Made A Profit During Coronavirus Peak
WORCESTER, MA — Tenet Healthcare, the for-profit owner of major hospitals in MetroWest and Worcester, saw its profits increase during the peak of coronavirus in Massachusetts, a time when the company furloughed local employees.
According to an earnings report released Monday, Dallas-based Tenet earned $88 million between April and June, more than triple the same period in 2019. However, the company saw a large drop in elective surgeries and other services due to the coronavirus pandemic, and overall revenue was down to $3.6 billion compared to $4.5 billion in the second quarter of 2019.


Despite pandemic, UMass Memorial reported $9.6M quarterly operating profit
The Worcester-based health system, however, didn't have as bleak of a financial quarter as could have been expected. In fact, it turned a $9.6-million operating profit in the three months ending June 30, according to financial documents released last week.

It's a sharp turnaround from the early spring, when Michael Gustafson, the president of UMass Memorial Medical Center in Worcester, predicted what he called by far the worst financial year in the history of the health system. That included a $40-million to $45-million loss in April and a $25-million loss in March, he said in a Worcester Business Journal online forum in May.

You would be amazed. Have you ever looked at Medicare fraud? I can't believe the number of professionals who put their licenses at risk for money.

Greed.

 

[Simply Southern]

I have a question: During Covid there were all these patients on vents- hospitals were bulging with patients- yet, some hospitals, for example Beaumont Hospital here in the Detroit area had to lay off a lot of staff because they were losing money: you may ask why were they losing money? because hospitals and docs make money on elective procedures which were not occurring at the height of the pandemic. I was surprised at that myself because i thought hospitals were making lots of money on patients who were on vents.

CMS is a diagnosis driven, flat rate payment system. The extra dollars were to assist with above and beyond additional cost.

Yes, ICU ventilator patients are usually paid at a higher rate, due to additional underlying diagnosis.

Ex...Hospital paid flat rate for stroke. Additional reimbursement for ICU, ventilator, TPN, paid with additional diagnosis of paralysis, COPD, respiratory failure, some type of diagnosis that would require ventilator.

The same would be true for Covid, with underlying diagnosis that would require ventilation.

Ventilator patients are in ICU, require highly specialized staff, experienced RNs, respiratory therapist and lots of one on one care. Lots of expensive IV pumps, monitors and more.

ICUs break even, at best, most lose money. The most profitable for hospitals is out patient services. Get you in and out, little nursing care required, bill it and the money in the bank in 7 days.

 

[weepingangel]

After 250 teachers seek leave of absence, school district switches to remote learning
New Jersey/ more at link
Following leave of absence or other workplace accommodation requests by at least 250 educators due to COVID-19 concerns, a New Jersey school district decided this week to switch to remote learning when the school year begins on Sept. 10, school officials said.

 

[CSIDreamer]

I just had a nasal swab test. Less than 2 hour results in the ER. Not pleasant but not too awful. Jmo

 

[weepingangel]

Negative hopefully?

I just had a nasal swab test. Less than 2 hour results in the ER. Not pleasant but not too awful. Jmo

 

[Simply Southern]

I just had a nasal swab test. Less than 2 hour results in the ER. Not pleasant but not too awful. Jmo

I hope you are OK.

Wow that quick.

 

[MimosaMornings]

I just had a nasal swab test. Less than 2 hour results in the ER. Not pleasant but not too awful. Jmo

Oh goodness you were in the ER? Hope you’re doing ok and you got a negative!

 

[weepingangel]

200-person party in Massachusetts town leads to $1,500 in fines
More at link/Massachusetts
Officials in a Central Massachusetts town handed out more than one thousand dollars worth of fines this week to those responsible for hosting a 200-person party over the weekend in violation of state restrictions issued in the wake of the coronaviruspandemic.

 

[weepingangel]

Locally so IMO no linky
hospitals are using their limited amount of rapid tests mostly for patients Being admitted to the floors via the emergency room

I hope you are OK.

Wow that quick.

 

[10ofRods]

I just had a nasal swab test. Less than 2 hour results in the ER. Not pleasant but not too awful. Jmo

I hope it was nothing serious that took you to the ER. And that your test is negative.

 

[MrX]

200-person party in Massachusetts town leads to $1,500 in fines
More at link/Massachusetts
Officials in a Central Massachusetts town handed out more than one thousand dollars worth of fines this week to those responsible for hosting a 200-person party over the weekend in violation of state restrictions issued in the wake of the coronaviruspandemic.

The U.S. really is unique in that thousands can gather legally in South Dakota, while 51 people could elicit fines in other places. Has anyone seen any advertising from State tourism agencies highlighting these differences - either "Come Here and Party," or "Come Here and be Safe?" The former would probably be looked at as being in bad taste, but it seems like business would be booming for things like concerts and festivals.

 

[CSIDreamer]

Negative hopefully?

I hope you are OK.

Wow that quick.

Oh goodness you were in the ER? Hope you’re doing ok and you got a negative!

Yes it was negative. Honestly I had a UTI go bad on me. I did not know these symptoms were UTI. Now I know.

 

[tresir2012]

What difference will knowing how many are tested make? There can be false negatives as well as false positives.
Death rates tell the story, not how many people were tested.

The deaths listed on the CDC link I posted showed a number for "probable" and a number for confirmed so even the deaths don't tell the story. The deaths also include more than 70,000 care home deaths that have overblown the count.