Just a heads up to fellow DU ers.

[Wellstone ruled]

The latest conspiracy story making the rounds after yesterday is,the Doctors as well as the Hospitals are reclassifying Patients deaths as Covid in order to bilk the Government out of extra tens of thousands of dollars .

Did a Google Search,appears this bullshit has a Appleton Wisconsin on air Talent working the Murdoch gig. And it comes from a interview she did with a Medical Doc from Minnesota a couple months ago. The Doc says it does not happen,if this is found to be true,that Hospital and Doc can be blocked from ever seeking reimbursement from any Federal Medical Program for ever.

Reason for the post is,had a Phone Call with a Family Member from the Midwest this AM spewing this garbage. Made a call to our RN Daughter working the trenches in Colorado,not happening and if it was,it would have to be a error which standard audits would catch each month. Check Google,and it traces this bogus story back to my unnamed person from Murdoch Media.

[WhiskeyGrinder]

1. That shit went around this summer, so this must be the second wave of it.

[NRaleighLiberal]

2. ah. same reason for climate change

they only seem to play one song

9 remaining days will undoubtedly raise all sorts of desperate bullshit from them.

[Kali]

3. not the latest

that BS was being spewed early on

[Brainfodder]

4. Reeks of desperation, and love it for that?

BUT ONLY THAT PLEASE!

[rzemanfl]

5. There is good reason not to trust anything out of Appleton, WI. n/t

[empedocles]

6. trump has been talking up the rumor/conspiracy

[uponit7771]

7. This stupidity started because of Birx !!! (link)

https://live.healthday.com/coronavirus-death-us-classification-2645672483.html

These people are stupid or against the truth, either one is hurtful.

[safeinOhio]

8. I saw JFK Jr. again today

at Wall Marts.

[Wellstone ruled]

12. Must have been in the Beer and Wine and Snacks Asile.

[MontanaMama]

9. Any doctor or hospital doing this

would be committing felony fraud. It’s not happening.

[beachbumbob]

10. QAnon stuff

[Wellstone ruled]

11. So the Fat Rat Basturd yesterday

spewed this crap at his Wisconsin Super Spreader event and no one from MSM did a push back. Thought this was debunked last spring,had to ask the smartest people in the world,fellow DUers. Thanks once again.

And yes,got a bunch of these Right wingers in the family. And yes,it gets worse. His Son works for Medtronic and is a Regional Pace Maker Sales Rep and believes this crap. Must be a family Gene that fortunately skipped me.

[FreeState]

13. Not new - I've been hearing this since April n/t

[Ms. Toad]

14. It's been making the rounds for months.

Trump revived it in one of his stump speeches in the last day or two.

[Wellstone ruled]

16. Never waste the time listening to the Fat Rat Basturd.

Not surprised after members clued me in. Just figured out how the story made the loop back to the Brother. Nephew is a Breitbart and Drudge subscriber and just relayed it back home.

[Ms. Toad]

17. I don't listen to him -

Too hard on my physical and emotional health.

But I do make it my business to catch the highlights (written as much as possible) so I know what new nonsense I'll have to counter.

[treestar]

15. It does not even make sense

Medicare would pay where applicable. It would not pay more for Covid-19 than for other things. Why would the hospital get more money for a COVID-19 case than for another?

[Ms. Toad]

19. Medicare's prices are based on what it costs to treat the condition

I know there was a move a while ago to pay a fixed amount for treatment based on condition, on the theory that while some will cost less and others more, on average the price would cover the treatment. The concept was to discourage doing additional testing or treatment in order to generate more fees.

I don't know if they actually went to that model.

But - COVID 19 (with venting, ICU, and isolation) is more expensive to treat - so it is likely that Medicare will pay more to treat a case of COVID than many other things that cause death. But it's because of hre care provided, not the cause of death listed on a death certificate.

[Hoyt]

21. For almost 40 years Medicare has been paying hospitals essentially based on typical cost for a

patient with certain diseases. There are adjustments to the basic reimbursement rate for the "Diagnostic Related Group" for comorbidities, outliers like when the patient is in the hospital longer than typical, etc.

There really is an incentive to code to the higher paying diagnoses; however, people are right that there are severe penalties for fudging it too far. A quick look indicates there is not much difference between reimbursement for say an average heart attack vs. CV19 until you start getting into ventilators.

To be clear, I think trump is full of chit and I enjoy seeing him squirm trying to explain away the fact he failed huuugely.


Here's a rough idea of what Medicare's system is for CV19. It varies by location, etc.

[Ms. Toad]

22. Thanks!

They must have been a more recent discussion - perhaps in connection with healthcare reform. I also note that these are treatment-related, not disease-related. (So - influenza, or non-COVID pneumonia, or some other respiratory diagnosis that required ventilation would be coded the same as COVID 19.

[Hoyt]

23. It's a different code range, buy yes the system is similar. Although I think payment is less for

influenza because of the required isolation, gowning up, drugs used, unknowns of new disease, length of expected stay, etc. The DRG reimbursement system is based on something approximating average costs. I think CV19 would be considerably more expensive now. Although I'd hope some day it's as easy to treat as influenza.


Some of the DRGs are (I can't find a good comparison on Influenza vs CV19, guess it's not as interesting to bloggers):

DRG 207 - Respiratory System Diagnoses with Ventilator Support. S-DRG 207 — Respiratory System Diagnoses with Ventilator Support >96 Hours, which has a relative weight of 5.4845. ... For MS-DRG 207 to be assigned to a claim, a beneficiary must have received 96 or more consecutive hours of mechanical ventilation.

DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT

[Ms. Toad]

24. How does that relate to the ICD-10-CM codes?

For example - PSC has always (until recently) been classed as K83.0 (general cholangitis). That created all sorts of challenges (from identifying a relevant patient population for study - to insurance denyting treatment that is appropriate for primary sclerosing cholangitis, even though it is not appropriate for treating general cholangitis). It's now classed as K83.01.

That code identified the specific disease being treated (which seemed to be the Trump allegation - was the the disease code was being used to generate higher fees).

The codes only listed a non-specific diagnosis (respiratory disease), as opposed ot COVID 19. So it appeared to be geared to treatment - not condition (at least not in any specific way).

Is there a different range for highly contagious, requiring special protocols - or is it specific to COVID 19 - highly contagious, requiring special protocols?

[Hoyt]

26. The ICD10 codes a doc uses for primary diagnoses are converted to DRGs.

They are closely related.

[Ms. Toad]

27. So the DRGs are more disease specific than appears

from the snippet you posted earlier?

[Hoyt]

30. Oh, yeah, that was a simple example. There are people who have worked

in the DRG field for decades who are still learning things.

It’s complicated, especially when hospitals want to maximize revenue and government, or private payers, want to control what they consider “upcoming.”

[treestar]

25. But then would the hospital have more profit for

treating more expensive conditions? It wouldn't unless they fraudulently claimed they treated for Covid rather than the other conditions. Such frauds could have been done before, too. And it would not be all that easy. Not as easy as the military does it.

[Hoyt]

29. Yes, CV19 pays more than pneumonia in vast majority of cases.

Now if the patient has CV19 AND pneumonia, that likely increases payment a bit. Sometimes the immediate cause of death or illness is not definite.

My personal belief is that if someone is admitted with CV19, that’s the immediate cause of death even if they came from a hospice with a terminal disease. If they are living with heart disease, dementia, kidney disease, etc., but are admitted needing acute CV19 treatment, that’s even more reason to list CV19 as cause of death if the succumb.

[treestar]

32. Yep, If they would not have died that day that they did

but for Covid, then the cause of death is Covid, IMO.

[sarcasmo]

18. Trump said that garbage during his hate rally here in Wisconsin last night.

[Wellstone ruled]

20. Thanks.

Just some more fake crap being spewed by a fake Actor who is playing President.

[Mariana]

28. This lie has been going around for months, in various forms.

Now, however, Trump is also saying it.

[flotsam]

31. It's pretty simple

If you go to your Doctor for a splinter he can easily code your Medicare charges as lung cancer and collect a shit ton of money and the only fly in the ointment is it's called "medicare fraud"...if you doubt this ask Rick Scott!