COVID Irregularities and Other Unanswered Questions

So, I know the last thing anyone wants to talk about is COVID, as that’s all we’ve been talking about for months.  I feel like we’ve been through an F5 tornado and like blind moles we’re just now beginning to come out of our shelters to see what the damages are.   

We’re also beginning to look at what we signed up for (or more accurately, what they signed us up for) in terms of legislation they push through every time we’re too busy dealing with a crisis to pay all that much attention.  Who can forget the Patriot Act after 9/11 where we later learned Congress had given up our rights to privacy and found we must now wait in line at the pharmacy counter to buy Sudafed in case we might be meth dealers.  (What that has to do with a terrorist act I don’t know, but it’s in there.)

It’s anybody’s guess what’s in that upteen page CARES ACT, but we’re already getting an inkling that it, too, is chock full of little surprises. 

Surprise #1:  Rep. Joe Courtney (D-CT2) introduced the legislation to the House on 1/24/19.  How could he have predicted an outbreak in China that we didn’t know about until January the following year?

Surprise #2:  At a White House coronavirus press conference on April 8, Dr. Deborah Birx reported that while some countries are reporting coronavirus fatality numbers differently, in the U.S. “you are counted as a victim of the pandemic if you die while testing positive for the virus, even if something else causes your death.”

This caused a stir here at Monomakhos because as healthcare professionals, George and I were weaned on the False Claims Act.  Because the provider payment amount is largely dependent upon the principal diagnosis, it would normally be against the law to say a patient died of something if they didn’t.   However, if they’re putting COVID on the death certificate, and according to Birx they are, it is reasonable to assume they are putting it on the claim, as well.

Monomakhos recently confirmed that COVID indeed makes it to the primary diagnosis spot on the claim if the patient is even suspected of having COVID.  What’s more, it must be the primary diagnosis or the entire claim can’t be paid. 

Surprise #3:  Including non-COVID deaths has obviously inflated the COVID mortality rate.  This is astonishing given that the elevated number of deaths due to COVID were the numbers that drove the models that confined us to our homes.  So how does this work? 

Hospitals run a COVID diagnostic test on every admitted patient.  If a man on Medicare is receiving palliative care (morphine) for end stage cancer and is determined to have the virus, they’ll say he died of COVID, even though he really died of metastatic cancer.  But they’ve gone even further than that. . . 

Surprise #4:  If, after taking his history, they find his daughter, Sue, who was his primary caretaker, had lunch with one of her Chinese friends who may or may not have COVID, the hospital will be reimbursed as if the patient died of COVID simply because they presume he might have had COVID, but died too soon to have the testing done.  The hospital would have bumped up their revenue by thousands of dollars for that case.  

Surprise #5:  Prior to the CARES ACT, if there was no evidence a patient died of something and a hospital purposefully billed under a phoney diagnosis, i.e. anything they could not support with evidence in the medical record, they could be fined a substantial amount of money.  It’s called “upcoding” and it’s a crime. 

During a pandemic, it wouldn’t be hard to manufacture something like this where a patient “sort of, could of, maybe had” COVID.  The incentive is there.  Economic assessments show if a Medicare patient is diagnosed with COVID, the hospital receives more money from the federal government to treat that patient and that amount can as much as triple if the patient requires a ventilator.  (BTW, George and I know of an excellent attorney if any of you even think you may have seen evidence of “upcoding”.  Whistleblowers are paid a lot of money for coming forward and the money they recover can save the taxpayer millions of dollars, as where you see one violation, you’re likely to see others. )  

Not long after Birx’s statement, Dr. Scott Jensen, a Minnesota family physician who is also a Republican state senator, told Fox News the following: “Right now Medicare is determining that if you have a COVID-19 admission to the hospital you get $13,000. If that COVID-19 patient goes on a ventilator you get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things [don’t have an] impact on what we do.”

He later recanted his more chilling remarks saying he has no evidence of a facility actually putting a non-COVID patient on a ventilator to they could be reimbursed a higher rate.  I believe him (I think) but the rest of what he said left some lingering questions:

Are providers “upcoding”?  The answer to this question has huge implications.  The financial incentive is there but would they do that?  You’ve got to wonder. 

The predicted numbers of COVID deaths are nowhere near what they thought they would be when they passed the CARES ACT.  So what happened to all the money that was spent but wasn’t needed?  As Americans, are we just supposed to suck it up and say to ourselves, “Oh well, sure they quarantined us, unnecessarily, and took away our jobs and income, but we’re fine with being taxed to offset a deficit of 6 trillion dollars for something that largely didn’t happen.”  I’m not sure that’s going fly.

Finally, they’re considering legislation where Americans will be expected to offset the costs of New York for not spending the money they needed to spend to take are of their own state when they were warned about the likelihood of an outbreak as far back as 2006.  Not sure how all you feel about bailing out another governor when your own governor put your tax dollars to good use but would love to hear your response.  

Stay tuned.  We’re likely to be talking about this for awhile.   

Mrs. Yours Truly



  1. The OP asks about the House Bill introduced in January 2019 on COVID-19. If you click on the links in the webpage, they show that whereas in March 2020 this was a COVID bill directed to treatment of small businesses regarding COVID, back in 2019, it was apparently introduced as a bill about small businesses without mentioning COVID: apparently it was introduced as a small business bill but then modified into a COVID bill on small businesses. On a sidenote, your larger point could still be correct that some experts or government staffpeople were expecting some kind of coronavirus outbreak in late 2019 – 2020

    • George Michalopulos says

      Hal, we still have to wrestle with the fact that Event 201 happened and that these directives which were put out by our jurisdictions were done lickety-split without any deliberation on the part of the hierarchy, clergy and laity.

      I’m sorry, but something doesn’t smell right.

    • Gail Sheppard says

      I’m not sure how it’s possible to even know what they were introducing in 2019 as the titles don’t match anything on the list of short titles that it had as it made its rounds through it’s various cycles. The short titles (below) were all about COVID. How does a bill about small business excise taxes turn into a law about a pandemic? Seems odd, doesn’t it?

      To your second point, there was something called Event 201 in the fall of 2019, with high level participation, to study what would happen in a pandemic. Their scenario sounds a lot like what really happened. It’s like they knew, too.


      The Event 201 scenario

      Event 201 simulates an outbreak of a novel zoonotic coronavirus transmitted from bats to pigs to people that eventually becomes efficiently transmissible from person to person, leading to a severe pandemic. The pathogen and the disease it causes are modeled largely on SARS, but it is more transmissible in the community setting by people with mild symptoms.

      The disease starts in pig farms in Brazil, quietly and slowly at first, but then it starts to spread more rapidly in healthcare settings. When it starts to spread efficiently from person to person in the low-income, densely packed neighborhoods of some of the megacities in South America, the epidemic explodes. It is first exported by air travel to Portugal, the United States, and China and then to many other countries. Although at first some countries are able to control it, it continues to spread and be reintroduced, and eventually no country can maintain control.

      There is no possibility of a vaccine being available in the first year. There is a fictional antiviral drug that can help the sick but not significantly limit spread of the disease.

      Since the whole human population is susceptible, during the initial months of the pandemic, the cumulative number of cases increases exponentially, doubling every week. And as the cases and deaths accumulate, the economic and societal consequences become increasingly severe.

      The scenario ends at the 18-month point, with 65 million deaths. The pandemic is beginning to slow due to the decreasing number of susceptible people. The pandemic will continue at some rate until there is an effective vaccine or until 80-90 % of the global population has been exposed. From that point on, it is likely to be an endemic childhood disease.

      Names of the CARES ACT as it went through the rounds:

      Titles (24)
      Short Titles
      Short Titles as Enacted
      CARES Act
      Coronavirus Aid, Relief, and Economic Security Act
      Short Titles as Enacted for portions of this bill
      COVID-19 Pandemic Education Relief Act of 2020
      Coronavirus Aid, Relief, and Economic Security Act
      Coronavirus Economic Stabilization Act of 2020
      Emergency Appropriations for Coronavirus Health Response and Agency Operations
      Relief for Workers Affected by Coronavirus Act
      Other Short Titles
      CARES Act
      Coronavirus Aid, Relief, and Economic Security Act
      Other Short Titles for portions of a bill
      COVID-19 Pandemic Education Relief Act of 2020
      Coronavirus Aid, Relief, and Economic Security Act
      Coronavirus Economic Stabilization Act of 2020
      Emergency Appropriations for Coronavirus Health Response and Agency Operations
      Relief for Workers Affected by Coronavirus Act

  2. George Michalopulos says

    Very well said Gail.  Truthfully, you’ve brought up some issues and tangents that I can’t wrap my head around.  Like the fact that Fauci is all over the place regarding this, that and the other thing.  Or that the CDC has downgraded the mortality rate to 1/4 of 1%.

    I hope that when all is said and done, we will have a fuller picture sooner rather than later.

    • Didn’t Fauci predict that the incoming administration would face a pandemic before Trump had even been sworn in?

      • Steven J. M. says

        As I remember it, he said they could be confident it would happen

        • Indeed. But why would he be so confident,
          confident it would happen in that particular four-year period?

          • Steven J. M. says

            Well – and do forgive me if this sounds a little crazy – but there’s this guy called Bill Gates, who’s right into vaccines and stuff. He and Fauci are like BFFs, and….na, couldn’t be

            • Nowadays, if you put 2 and 2 together and come up with a number somewhere between 1 and 37, you are clearly crazy.

              Like me.

  3. GCU Except at Waffle House says

    Surprise 1 is only a surprise if you don’t know that Congress is a weird institution with a lot of quirks. Gather round lads and lassies! So, one thing I think we all know is that the normal pace of Congress is, well, really slow. There are a lot of procedures and pieces and parts they don’t bother getting into in Schoolhouse Rock. What that means, is in a case where Congress is trying to do something in an expedited fashion, some of the shortcuts look rather odd. And they are!
    With the current makeup of Congress, the heavy lifting to get something to the President’s desk is getting something that will get 60 votes in the Senate, which requires bipartisan support. Even if that weren’t the case, it isn’t unusual for the Senate to be taking point anyway.
    So what the Senate did, is they took a previously passed piece of legislation in the House, that was never going to be even considered for a vote (McConnell called himself the Grim Reaper for his collection of these), which was a bill that needed to have originated in the House and…
    Select All. Delete. Paste. Quite literally! You can see it on the Congress page, the text of the original bill was replaced on March 25 with a header that says “Resolved, That the bill from the House of Representatives (H.R. 748) entitled “An Act to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage.”, do pass with the following”. And then a zillion pages of original CARES act text.
    And that was passed in the Senate and then sent back to the House since the Senate modified the previously passed House bill. But passing in the House was the easy part.
    tl;dr no smoking gun of conspiracy, just a shortcut. It is far from the first time the Senate has done that particular trick.
    I’m still facepalming that after original SARS and MERS that people think it suspicious that a novel coronavirus based on SARS would be the subject of a pandemic exercise. How dare people who do that stuff for a living be able to make a realistic projection for a scenario. Why couldn’t they just rip off The Andromeda Strain?
    WaPo did some digging into emerging excess mortality data the other day:

    • Gail Sheppard says

      Not saying you’re wrong, but can you give me one example where this sort of thing has happened before? Where they took a bill from the House, rewrote it, gave it to the Senate who put together a humongous document in 2 months, passed it, and sent it to the White House?

      • GCU Except at Waffle House says

        I’m not sure precisely what you mean by “sort of thing has happened before?” The replacement mechanics themselves has a specific wonky term: amendment in the nature of a substitute. 
        Now, the CARES Act was certainly an extraordinary use of it, but then the CARES Act was an extraordinary bill. It isn’t really accurate to say it was put together in 2 months, it was assembled on the fly in March as COVID-19 kept snowballing. It would be more accurate to say it was hastily assembled in 2 weeks as an emergency measure in response to dire circumstances. Which, of course, means that wherever a person might be on the political spectrum, you can find plenty of valid criticisms of the bill. 
        It was a giant, expensive, flawed, hastily thrown together piece of legislation. But the haste was why amendment in the nature of a substitute was used, it let the Senate quickly get to a vote while respecting the origination clause. There was no secret bill waiting in the wings that was suddenly unveiled. Major changes happened in the last 72 hours when the Democrats played hardball on cloture when McConnell tried to bring an early version to a vote! A great deal on the tick-tock was written in the political press throughout because it was an extraordinary response to an extraordinary situation.

  4. Sage-Girl says

    We cannot go to church + couples cannot hold hands … but you Can go to protest & you Can be for ANTIFA + rioters burning down the town ! This is the zeitgeist, the leftist media tolerates

  5. Sage-Girl says

    God help us —
    what will happen 2 weeks from now from crowds of protesters at Riots in cities infected with Virus! And we need our police healthy, not infected by thugs so they can do their job.

  6. ” German Official Leaks Report Denouncing Corona as
    ‘A Global False Alarm’ ”

  7. This is well worth a read:
    “LOCKDOWN LUNACY: The Thinking Person’s Guide”

  8. This is priceless: – “Can’t We Just Say It?”

  9. They have come for Scott Jensen: