April 16, 2020

CARES Act Pays Hospitals To Report COVID Patients, Even Those Presumed

Last week, Dr. Deborah Birx, a medical expert on the White House Coronavirus Task Force, made a statement that for many questioning the current coronavirus numbers raised eyebrows. “If someone dies with COVID-19, we are counting that as a COVID-19 death,” said Birx, who added that it was based on if a person carried the virus, rather than if they died due to the virus or other extenuating circumstances.

“In this country, we’ve taken a very liberal approach to mortality and I think the reporting here has been pretty straightforward over the past five to six weeks,” she said.

“Prior to that, when there wasn’t testing in January, February that’s a very different situation. There are other countries that if you had a pre-existing condition and let’s say the virus caused you to go to the ICU and then have a heart or kidney problem – some countries are recording that as a heart issue, kidney issue and not a COVID19 death. Right now, we’re still recording it and the great thing about having forms that come in and a form that has the ability to market as COVID19 infection, the intent is right now if someone dies with COVID19, then we are counting that as a COVID19 death,” she added.

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Upon SaraACarter.com’s review of the CARES Act, Dr. Birx left out a significant detail in the numbers and a key incentive driving the reporting.

Under the legislation, hospitals can receive 15 percent additional funding from Medicare if they report patients who aren’t initially admitted to the hospital for COVID-19 but then while admitted either test positive initially or as ‘secondary diagnosis.’

The bill states: “For discharges occurring during the emergency period described in section 1135(g)(1)(B), in the case of a discharge that has a principal or secondary diagnosis of COVID–19, the Secretary shall increase the weighting factor for each diagnosis-related group (with such a principal or secondary diagnosis) by 15 percent.”

There is also a reported skew in COVID-19 fatality reports and the new information provides a foundation for that.

In fact, this week the CDC changed the rules for reporting cases saying that a patient who doesn’t take a test for the virus, but is presumed to have it will be counted. The CDC also recommends that COVID-19 deaths be reported based on the information provided by hospitals.

“When reporting cause of death on a death certificate, use any information available, such as medical history, medical records, laboratory tests, an autopsy report, or other sources of relevant information. Similar to many other diagnoses, a cause-of-death statement is an informed medical opinion that should be based on sound medical judgment drawn from clinical training and experience, as well as knowledge of current disease states and local trends,” the CDC advises.

New York City officials said Tuesday that the city would begin counting presumed COVID-19 deaths for patients who never underwent testing for the virus.

After the announcement was made, the city’s death toll jumped by 3,700 fatalities. The current nationwide case count is 635,825 and the number of deaths is 30,998.

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