TheOctopus
Banned
- Joined
- Apr 4, 2013
- Messages
- 1,622
- Thread Author
- #121
While your tone is very condescending, I will reply but will ignore your posts if it continues. I have already stated that I only post that which I am sure of. Stop being naïve, there are billions of dollars involved with Medicare Fraud and Abuse annually. There are Medicare task forces that arrest people for it. 2020 was no different and some will pay for it when they catch up with them.
"Given this 20 percent increase in payment associated with the COVID-19 diagnosis for hospitalized Medicare patients, there has been speculation that this “windfall” is incentivizing fraudulent behavior. Headlines have claimed that because hospitals are getting paid more for patients if they include a COVID-19 diagnosis on the patient’s chart, and are paid even more for each COVID-19 patient on a ventilator, some hospitals are adding the COVID-19 diagnosis to the charts of patients who do not actually have COVID-19.
Also...
When it comes to the $100 billion fund to help providers, future grants by HHS are supposed to focus on providers in areas hit hard by the outbreak, among others. But the initial allocation of $30 billion from that $100 billion fund to assist hospitals wasn’t distributed in that way. Instead, it was based on prior Medicare business.
A Kaiser Health News analysis found that the distribution of that initial $30 billion resulted in hospitals in states less affected by the pandemic — such as Minnesota, Nebraska and Montana — being given funding that worked out to be about “$300,000 per reported COVID-19 case.” In New York, which has the highest number of COVID-19 cases, the grant money amounted to “only $12,000 per case.”
Also...
"Many health-care companies and hospital industry groups are fighting a Trump administration policy tying extra federal coronavirus reimbursements to test results proving that patients are positive for Covid-19, saying the requirement unfairly deprives them of relief money established by Congress.
Legislation in March provided hospitals a 20% boost to the standard federal Medicare reimbursement for each patient admitted for coronavirus.
But the Centers for Medicare and Medicaid Services added a requirement, which took effect Sept. 1: For hospitals to receive the funding, each patient must have a documented positive Covid-19 lab test.
CMS officials said the requirement was added to protect against fraud since the funding was increased. “As part of Medicare’s longstanding standard payment policies, Medicare providers are required to accurately document and bill for services provided based on a beneficiary’s diagnosis,” a spokesman said.
CMS is concerned that without a lab test showing someone has Covid-19, hospitals may code them incorrectly as having the virus and erroneously receive the 20% add-on. The agency said that it will review patient records after payments are made to confirm positive test results, and those lacking results would see their payments accounted for as overpayments."
