Sunday, September 15, 2024

ZOWE SMITH: Patients on ventilators for over 30 days [hospitals got] over $1 million . . .

 "In 11 years of medical coding I've never seen a case of pneumonia that ended up with massive organ failure, ventilator for 30 days, and death...it all happened around the COVID [testing/bonuses.]"

"Patients were on ventilators for over 30 days...[that's]...over $1 million..." Medical whistleblower, author, and former medical coder Zowe Smith (
@Zowe_TKMC
) describes for Weezy on the What is TRUTH? PODCAST (@WhatTruthPod) how hospital protocols changed once COVID testing and bonuses were implemented due to the CARES Act. (Which was signed into law by President Trump in March 2020.) "If you go through the CARES Act line by line, you're not gonna see something that says, 'If you put a patient on a ventilator, you get a 20 percent bonus.' However, if you understand the payment system of coding, it's there," Smith says. The whistleblower adds that patients who were put on a ventilator for 96+ hours were placed into the highest payment category. "If your DRG [diagnosis related group] was COVID and you're on a ventilator, you get a 20 percent bonus just for having COVID, and then you also get the bonus because you're bumped into the highest paying category for that diagnosis related group because of the ventilator use," Smith adds. Furthermore, the whistleblower notes that "there was [also a] bonus for [use of] Remdesivir." "They considered Remdesivir a new-tech drug and it was Gilead, Fauci, and the NIH that developed Remdesivir and decided we should be using it...So every single dose, every individual dose that they gave you of Remdesivir, gets them a 20 percent bonus. So that was hella money for them [the hospitals]." Indeed, Smith notes that these bonuses were the saving grace of hospitals who were in severe need of revenue, as the COVID "lockdowns" in 2020 starved them of patients. "Imagine being bankrupt and all of a sudden you see all these bonuses coming at you. If you're a hospital admin and you're responsible for the financial health of that hospital, and you see all these bonuses coming in, I bet you're gonna be telling your other buddies in admin to use those those protocols so you can get those bonuses so you can keep the doors open." Smith adds: "During the scamdemic, especially before the vaccine, I think they were practicing these hospital protocols that were killing people. Because before COVID, if you came in with pneumonia or cold or flu, you would you'd be home within 3 days probably. You almost never be put on a ventilator. We never treated it like that. There's never been I've never seen in 11 years of medical coding, I've never seen a case of pneumonia that ended up with massive organ failure, ventilator for 30 days. So something very, very different happened and it all happened around the COVID testing and the COVID bonuses." Partial transcription of clip: "Because patients were on ventilators for over 30 days, some of them. So that's an extremely long stay. That all I mean, that's very rare to have a stay like that, and they're almost all over a million dollars when you get to a stay that's that long. "And and when you couple that with. So, yeah, I believe it was up to 30,000 dollars in just bonuses, like, on top of their regular payment. Because what so this is kind what what people don't understand about the bonuses and and one of the things that I can't explain really well about bonuses is the ventilator bonus. So if you go through the CARES Act line by line, you're not gonna see something that says, if you put a patient on a ventilator, you get a 20 percent bonus. However, if you understand the payment system of coding, it's there. So, it for an inpatient, it goes to what's called IPPS, which is inpatient prospective payment system. It's a Medicare system. DRG means diagnosis related group. So what they do what Medicare's done is data mined all of these diseases. They've data mined all the treatments that it takes, and they've come up with, like, an average or a standard of care. And so they're like, a DRG for a heart attack, for example, they're gonna say these are the average day is x amount of days. "The average treatment is, you know, bypass CT scan, these certain labs, whatever, you know, kind of standard treatment it is, you know, whatever the drug standard treatment is. They know the average cost of all of that. And so they'll say, okay. This is the basic charge we're gonna pay you for that. So for an inpatient stay, they can't nickel and dime you for everything.
So you're not gonna see a charge for every single lab they do. You're not gonna see a charge for, you know, every single drug they give you or every band-aid they put on you like you will on an outpatient case because those are all individually charged if you're an outpatient.
When you're an inpatient, it's all, like, one bulk payment. So they've averaged out what all of this is, and they have a 3-tier payment system. "So for a heart attack, there will be, like, level 1, which is the lowest, level 2 where you get, like, a cc, which is called the comorbidity. You get more payment for that. And the third high or third one is the highest tier, and that's where you have the MCC or a major comorbidity, and that will get you the the highest payment that you can for that diagnosis. So ventilators are broken into the code itself, the procedure is broken into 3 different times. It's broken into less than 24 hours. That puts you in the lowest tier. Above 24 hours to 96 hours, that puts you in the middle tier for the CC. And then if you're over 96 hours on a ventilator, doesn't matter how many more days after that, there's one procedure code for over 96 hours.
"And, that will put you in the highest payment category. So they were getting 20 percent bonuses on top of their DRG. So if your DRG was COVID and you're on a ventilator, you get a 20 percent bonus just for having COVID, and then you also get the bonus because you're bumped into the highest paying category for that diagnosis related group because of the ventilator use.
And then there was the bonus for the Remdesivir. So there's something called new technology and when a new technology code comes out, it's a new procedure that we haven't done. Medicare hasn't data mined all this information. So it's considered high risk. So they're they usually pay a lot higher because this is kind of it's considered experimental until they have years and years of data saying what safety is. "So they considered Remdesivir a new tech drug and it was Gilead, Fauci, and the NIH that developed Remdesivir and decided we should be using it. What was Gilead that applied for the new tech bonus? So every single dose, every individual dose that they gave you of Remdesivir gets them a 20 percent bonus. So that was hella money for them. So imagine being bankrupt and all of a sudden you see all these bonuses coming at you. If you're hospital admin and you're responsible for the financial health of that hospital, and you see all these bonuses coming in, I bet you're gonna be telling your other buddies in admin to use those those protocols so you can get those bonuses so you can keep the doors open. "So...during the scamdemic, especially before the vaccine, I think they were practicing these hospital protocols that were killing people. Because before COVID, if you came in with pneumonia or cold or flu, you would you'd be home within 3 days probably. You almost never be put on a ventilator. We never treated it like that. There's never been I've never seen in 11 years of medical coding, I've never seen a case of pneumonia that ended up with massive organ failure, ventilator for 30 days. So something very, very different happened and it all happened around the COVID testing and the COVID bonuses."
Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)