Upcoding & the False Claims Act COVID Style

Xtra!  Xtra!  Better read all about it now.  This clip has been pulled so often it’s hard to keep track.  But it speaks to what we were talking about earlier and how they’re turning the death of a patient who tests positive for the coronavirus, into a “COVID death” regardless of what the patient may have really died of

They probably test for corona everytime someone presents with flu-like symptoms, which can be caused by a host of bacterial, viral or even fungal infections.  Parasites can cause flu-like symptoms, as well. 

So if you test positive for COVID, but you die of coccidioidomycosis, a fungal infection commonly known as valley fever, which causes fever, chest pain and coughing, they’re going to report to the government that you were a COVID death and bill the government accordingly.     

This is called “upcoding” and it’s done to increase reimbursement, which is a blatant violation of the False Claims Act.  

* * *

Physicians Say Hospitals Are Pressuring ER Docs to List COVID-19 on Death Certificates. Here’s Why

The economic incentive to add COVID-19 to diagnostic lists and death certificates is clear and does not require any conspiracy.

When Drs. Dan Erickson and Dr. Artin Massihi of Accelerated Urgent Care held a press conference last week, their goal was to galvanize policymakers to reopen the economy.

The California-based hospital owners may have uncorked a bigger story.

During their long discussion with reporters, Dr. Erickson noted he has spoken to numerous physicians who say they are being pressured to add COVID-19 to death certificates and diagnostic lists—even when the novel coronavirus appears to have no relation to the victim’s cause of death.

“They say, ‘You know, it’s interesting. When I’m writing up my death report I’m being pressured to add Covid,’” Erickson said. “Why is that? Why are we being pressured to add Covid? To maybe increase the numbers, and make it look a little bit worse than it is?”

The longtime ER doctors, who had their video removed from YouTube after the American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM) jointly condemned their briefing, aren’t the only ones to say COVID-19 is being classified uniquely. (There’s reason to question some of the snap conclusions the physicians reached in their briefing, but YouTube’s decision to ban them is absurd, if predictable.) 

Earlier this month, Illinois’s top health official explained that any victim diagnosed with the novel coronavirus would be classified as a COVID-19 death—regardless of whether it contributed to the patient’s death.

“If you died of a clear alternate cause, but you had Covid at the same time, it’s still listed as a Covid death,” Dr. Ngozi Ezike, the director of Illinois’s Department of Public Health, explained to reporters.

Not all states have taken an approach as direct as Illinois’s, but even where state guidelines don’t call for listing the mere presence of COVID-19 as the cause of death, it appears hospital administrators are taking a proactive role.

When a reporter asked Erickson who was applying the alleged pressure on physicians, he said it was hospital administration.

“We’re being pressured in-house to add Covid to the diagnostic list when we think it has nothing to do with the actual cause of death,” Erickson said.

So are hospitals conspiring to gin up COVID-19 deaths to make the pandemic look worse than it is? Probably not. There’s a simpler explanation: incentives.

As Minnesota lawmaker and longtime family practitioner Dr. Scott Jensen recently observed, hospitals are incentivized to pressure physicians to include COVID-19 on death certificates and discharge papers, since the CARES Act increases Medicare payments to hospitals treating COVID-19 victims.

“Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it’s a straightforward, garden-variety pneumonia that a person is admitted to the hospital for—if they’re Medicare—typically, the diagnosis-related group lump sum payment would be $5,000,” said Jensen, whose claim was fact-checked by USA Today. “But if it’s COVID-19 pneumonia, then it’s $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000.”

The idea that physicians would be pressured to list COVID-19 on death certificates even when it appears the virus had little or nothing to do with someone’s cause of death might sound crazy, but some would say it was entirely predictable.

“We aren’t pressured to test for flu. Why are we being pressured to add Covid?”

“Show me the incentive and I’ll show you the outcome,” American businessman Charlie Munger once observed.

The economic incentive is clear and does not require any conspiracy.

By creating a massive federal program that links goosed Medicare payments to COVID-19 treatments, the feds incentivized hospitals to add COVID-19 to diagnostic lists and death certificates. It also incentivized hospitals to get patients on ventilators, which may have done more harm than good, as hospitals have reported unusually high fatality rates for COVID-19 patients on ventilators.

“We aren’t pressured to test for flu,” Dr. Erickson said during his press conference. “Why are we being pressured to add Covid?”

The simple answer is this: incentives matter.

It’s a lesson policymakers in Washington, D.C.—who’ve also managed to create an employment structure that pays many workers more to stay home than go to work—seem to never learn.






  1. Antiochene Son says

    However particular deaths are classified, CDC data shows that deaths overall are significantly higher than average over the last 4 to 6 weeks.
    If upcoding is happening and these people would have died anyway, we should not see a spike like this. Or if Covid19 merely accelerated what would have happened anyway, we should see the death rate fall below normal soon, as those who would have died weeks or months from now died earlier. 
    I don’t buy the incentive thing, because hospitals get far less money for a covid patient than they would have gotten for all the elective procedures that have been canceled. Hospitals have a greater interest than most to get rid of these restrictions. I have relatives in Healthcare who have been laid off because of this, and executives are taking significant losses as well. 
    Still, at least in my area the hospitals are doing their own modeling and expect the peak later in the year, mid-July or later, and still running out of ICU beds. 
    In any case this isn’t over; to achieve herd immunity 70% or more will have to have antibodies, which is about 240 million people in the US. Even if the death rate is just 0.2%, that’s half a million deaths and probably 5 million ICU admissions.
    It may not be as bad as we expected six weeks ago, but it’s still bad enough. 

    • This is a really good point about excess mortality, which anyone who claims that upcoding is falsely inflating numbers needs to address.

  2. Fr. Deacon John says

    I knew a guy many years ago whose favorite quote was – “Figures don’t lie but liars figure”…..

  3. Sage-Girl says

    I phoned Fr. John of our NY Cathedral to ask  if he knew how many from church got sick — out of 400+ parishioners, about 15 were hospitalized but now recovering at home – 5 rarely attended, only 2 died.  And it’s amazing very few priests in NYC Epicenters have been reported sick ??
    Among a few friends + myself, we all got unusual “cold” back in Dec.Jan.Feb., a hacking cough but no nasal symptoms like typical cold, so I wonder, did we get the Virus already??

    • Gail Sheppard says

      It sounds like you may have already gotten it, too.

      • George Michalopulos says

        FWIW, I’m pretty sure I got it back in late January myself.  Possibly Gail as well.

    • Rhipsime says

      In my family, the weird sickness stuff started right after Labor Day, just after a relative from Chicago visited. Curiously enough, she worked at an assisted living facility.  It took months to cycle through it all, and I was told I had developed pneumonia, and my daughter ” borderline ” pneumonia.  I know this doesn’t jive with the official timeline, but considering how puzzled the doctors seemed with some of this, such as incredibly sore throat/coughing/mild fever with no stuffiness or strep, I bet you this is what we had.  Furthermore, the little kids (ages 2 &5) hardly seemed to be affected at all… a couple days of less energy, but that was about it.

  4. Monk James Silver says

    Christ is risen. truly risen!
    Since I’m generally not sympathetic to conspiracy theories, dear George, I’m taking this report with a generous helping of salt.
    Apart from my resistance to the report’s underlying ideas, though, is a medical consideration.  We’ve been consistently warned that various comorbidities make some people more susceptible to COVID-19 infection than others who are in better health.  This susceptibility is an important factor in accurate diagnostics.
    So, then, if someone dies of diabetic complications or COPD or any one of a dozen other diseases and is NOT diagnosed as also having been infected by COVID-19, the cause of death is fairly clear and straightforward.  But if COVID-19 is also present, the cause of death is not so clear, since that particular infection may have made some patients unable to recover from even a relatively minor crisis brought on by one or another of their comorbidities.
    It may well be that this particular  observation recommends identifying COVID-19 as the ultimate cause of death rather than any of the other previously identified diseases, and that medical professionals are not ‘upcoding’ (or being forced to ‘upcode’) merely to attract financial support.

  5. George Michalopulos says

    As much as I hate to do this, I’ve got to give Elon Musk (otherwise a well known charlatan and rent-seeker extraordinaire) his due for pointing this out:


    Namely that the corona virus was never in any danger of overwhelming the California hospital system. In the interest of fairness, I’ve got to give credit where credit is due.


  6. This is identical to schools being incentivized to label boisterous students as mentally deficient in many ways: adhd, add, autistic, etc. as schools are paid more per student when this designation is in place.  It will, of course, negatively label the student as special needs (more times than not) and be encouraged if not demanded to be prescribed medications which pose problems later on…

    • Brendan says

      “It will, of course, negatively label the student as special needs (more times than not) and be encouraged if not demanded to be prescribed medications which pose problems later on…”
      …and, of course, less will be expected of the student;
      which expectations he or she will very likely fulfill.

      • cynthia curran says

        No help as a kid. My father was a poor reader so I got those genes. The student system by my day did label kids thought as poor readers with some hyperactivity as special  needs while in my father’s day he was not. However, since he was a poor writer he failed freshman compostion in community college. Both my father and I had to pick up things on our own since the school systems we were educated in didn’t help much for our true problems like in reading, and writing.

    • Mamma Mia says

      It is extremely difficult to get the schools to identify students with special needs.   Yes, there is more funding, but any parent who has been through the IEP process will tell you that it is not easy.   There ARE children who do need additional learning adjustments in the classroom – and beyond.    This has nothing to do with the massive coding of deaths as COVID.  

      • Gail Sheppard says

        I think Eleni was talking about the disparity between what is (true number of COVID deaths) and what people say it is (inflated number of COVID deaths) which often results in negative consequences, like over diagnosing the behavior of a child as being outside the norm and putting them on medication. I went through this with my son who was one of the first children diagnosed with ADHD for being “wiggly” in kindergarten. The saddest thing is, I bought into it. – He was an alpha male and in today’s world, alpha males require “additional learning adjustments in the classroom – and beyond” because it makes the teacher’s job easier. I wasn’t put on this planet to make a teacher’s job easier. I was put on this planet to protect my children and in this regard, I failed.

  7. cynthia curran says

    Elon Musk thinks a little differently than his co-technie brothers since he grew up in South Africa not the US. So, he can go against them on  the lockdowns since he wants to do Tesla production. 

  8. George Michalopulos says
  9. https://townhall.com/columnists/kevinmccullough/2020/04/23/antibody-testing-proves-weve-been-had-n2567516
    I perused this over at Townhall.  Hard to say which is the greater fiasco, the Spygate thing or the Kungflu.  Six to five and you pick em.

  10. Ioannis says

    Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study.


    See the graph at the end

  11. Here is a comment from an article on Covid-19 and
    Western collusion in Chinese chimera virus research:


    May 3, 2020 at 7:11 am

    The Plot Thickens… From [ https://e-catworld.com/2020/05/02/covid-19-thread-5-2-2020-study-finds-correlation-between-vitamin-d-levels-and-deaths/ ]“Other studies of Vitamin D suggest the same:
    “The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patientshttps://www.medrxiv.org/con
    Vitamin D Insufficiency is Prevalent in Severe COVID-19https://www.medrxiv.org/con
    Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths.https://www.ncbi.nlm.nih.go
    COVID-19 Deaths Are Being Linked to Vitamin D Deficiency. Here’s What That Meanshttps://www.sciencealert.co…3 •Reply•Share ›”
    In other words, telling Floridians not to lie on the beach to produce Vitamin D, and restricting elderly to their homes instead of camping and park experiences is a death sentence. And an expensive drug is recommended over less expensive approaches…To me, all part of an unconscious pattern.”

    Here is the article:
    Were Dangerous Wuhan Coronavirus Lab Experiments
    Part Funded by Western Governments?

  12. George Michalopulos says

    Looks like “upcoding” is a historian’s problem as well:


    Upshot: the Plague of Justinian may not have been as widespread as the primary sources indicated.

    • cynthia curran says

      Well Justinian survived it. In fact Justinian lived in an age where historians exaggerated things including the plague.

  13. “Why lockdowns are the wrong policy – Swedish expert Prof. Johan Giesecke”

  14. George Michalopulos says
    • Sage-Girl says

      George – yes,
      ? at NY Cathedral we just lost a dear cantor to the Virus – Daniel was overweight + with underlying health issues – said his mother. Fr. John will pay respects during Livestream this Friday 11:30 am on YouTube.
      In total we’ve lost 3 + about two dozen are hospitalized or sick at home… 

  15. George Michalopulos says

    How come this “whistleblower” didn’t have to give his testimony under oath?

    Kinda makes you go “Hmmmmmm…….”


  16. George Michalopulos says