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VERIFY: Are there incentives for hospitals to make money from COVID?

13News can verify hospitals have and are receiving reimbursement for the treatment of COVID.

INDIANAPOLIS — Hospitals were hit hard by COVID-19. Not just the impact of treating the sickest patients but a financial hit as well. For months, many hospitals had to shut down elective surgeries and other services.

Congress recognized the revenue losses and provided some help. But that has sparked non-stop talk about whether hospitals are getting a financial windfall.

QUESTIONS

Our VERIFY team is answering ongoing questions: Specifically, are there incentives for hospitals to make money from COVID?

From the onset, it's important to understand hospital reimbursements and funding are complex.

So the 13News VERIFY team started with basic questions such as:
"Do hospitals really get money for COVID cases??"

And "true or false? Hospitals get paid x amount of money for however many COVID patients they have. More if they are on ventilators?"

ANSWER

Yes, it's true hospitals are getting money for treating COVID patients, but it's not that simple.

SOURCES

Our VERIFY team turned to the Centers for Medicare and Medicaid Services or CMS, Health and Human Services and the Indiana Hospital Association for answers.

THE FACTS

CMS routinely provides reimbursements to hospitals for treating patients on Medicare. Medicare is a federal health insurance program for those over 65.

In April, during the height of the COVID-19 crisis, Congress created a $100 billion fund under the CARES Act to assist hospitals and to provide Medicare reimbursements for COVID-related treatment. The amounts provided were 20 percent more than typical reimbursements.

"The cost associated with treating COVID patients are significant," said Brian Tabor, president of the Indiana Hospital Association, which represents 170 facilities across the state. But Tabor said it's important to note hospitals are not recouping all of their expenses.

"Especially when you talk about government reimbursement, it is almost always well below the cost of delivering those services. So these payments absolutely helped," Tabor told 13News.

Hospitals and other health care providers were allowed to access payments from two agencies.

CMS provided advanced Medicare reimbursement payments based on rates individual hospitals received in 2019. But that money must be paid back.
Payments from HHS and the CARES ACT targeted COVID hot spots, rural areas and safety net hospitals.

13News can verify hospitals have and are receiving reimbursement for the treatment of COVID.  

Credit: Getty Images/iStockphoto
FILE PHOTO: Woman lying in a hospital bed after a COVID-19 test.

QUESTIONS

Still more questions: 

But what about persistent claims that COVID numbers are inflated to make money? 

Also, one viewer asked:

"There is a rumor going around that hospitals are intentionally labeling deaths unrelated to COVID as COVID deaths... solely for monetary gain."

And another similar claim:

"Do hospitals get benefits from recording all deaths saying they are caused by the coronavirus?"

THE FACTS

"The notion that the numbers have somehow been manipulated is just absolutely false," Tabor said. "There is a lot of documentation in the medical record, test results, all sorts of things that have been sent to the government to help show that these COVID cases are absolutely real."

In Indiana, the State Department of Health also keeps close track of COVID hospitalizations, the number of ICU beds and ventilators. The information is updated daily on the state's public website.

Tabor said he's surprised the initial questions have morphed into so many other areas.

"Hospitals do not receive more money when a death is coded as COVID," he said, calling the claim a myth.

While hospitals face extensive reporting requirements, to date no group or organization can provide anything showing data is manipulated to get more money for COVID treatments or COVID-related deaths.

13News can verify both of those claims are false.

If you see something online that sounds odd or hard to believe, or if you hear information that you’d like us to confirm, we’ll fact check it for you. Send 13News your question to verify@wthr.com.