Physicians are paid based on procedural care. We receive a set fee for doing something – a history and physical, an operation, your daily care in the hospital. Those fees are set annually. When a physician is paid to care for a patient with pneumonia or sepsis, two of the common COVID-19 pathways, there is no difference in payment based upon the organism causing the illness. No physician receives a penny more or less for treating a COVID-19 patient or one with pneumococcal pneumonia.
As with all good misdirection, a nugget of truth deep in the center of the lie does provide some credibility. Hospitals receive a “bundled” payment for a hospitalization based upon the severity of illness and what is being treated. Because of the unique nature of COVID-19, the federal government paid an additional component to hospitals for patients with a primary diagnosis of COVID-19 – the virus had to be the reason for admission. For several months, early in the pandemic before testing was widely available, hospitals were allowed to claim the patient had COVID-19 without a verified test. That rule was changed several months ago, as testing became more accessible, and to qualify for that extra money, hospitals need to demonstrate a laboratory proven infection with COVID-19. Perhaps some hospitals, in a time of medical chaos, as we tried to find some form of effective treatment, took advantage and claimed a COVID-19 case that wasn’t, but there is no proof of that. Further, it is illegal, and being caught in that way results in significant fines and penalties.
