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Reader: I have a question about Covid19 treatments for which hospitals were paid. I understand hospitals were paid $13,000 for each patient that diagnosed as dying from Covid19. I also understand that hospitals were paid $35,000 for each Covid19 patient put on a ventilator. In addition there is the drug Remdesivir. How much money were the hospitals paid IF they administered Remdesivir to a Covid19 patient?
FactCheck.org Director Eugene Kiely: We wrote about this topic in a story called “Hospital Payments and the COVID-19 Death Count.” The story addressed the unsupported claim that hospitals were inflating the number of COVID-19 deaths to make money. We found no evidence of that.
As we wrote, the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, which became law in March 2020, pays hospitals higher Medicare rates for COVID-19 patients and treatment, but there is no evidence of fraudulent reporting. The CARES Act pays an additional 20% on top of traditional Medicare rates for COVID-19 patients during the public health emergency, and by reimbursing hospitals for treating the uninsured patients with the disease (at that enhanced Medicare rate).
The payment for remdesivir and other treatments would be included in the enhanced payments for treating COVID-19 patients.
Our story says:
Medicare — the federal health insurance program for Americans 65 and older, a central at-risk population when it comes to COVID-19 — pays hospitals in part using fixed rates at discharge based off a grouping system known as diagnosis-related groups.
The Centers for Medicare & Medicaid Services has classified COVID-19 cases with existing groups for respiratory infections and inflammations. A CMS spokesperson told us exact payments vary, depending on a patient’s principal diagnosis and severity, as well as treatments and procedures. There are also geographic variations.
An analysis by the Kaiser Family Foundation looked at average Medicare payments for hospital admissions for the existing diagnosis-related groups and noted that the “average Medicare payment for respiratory infections and inflammations with major comorbidities or complications in 2017 … was $13,297. For more severe hospitalizations, we use the average Medicare payment for a respiratory system diagnosis with ventilator support for greater than 96 hours, which was $40,218.”
The public health emergency for COVID-19 is still in effect. The secretary of the Department of Health and Human Services has repeatedly extended the public health emergency for 90 days at a time, most recently on Jan. 11.
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