So, I have read some on this specific issue this am, because it is certainly a very serious issue. From what Ive gathered, it stems mostly from an interview with Minn State Senator Jansen on FOX. The numbers listed are pretty accurate under the legislation passed for our COVID response. However, that Senator was specifically asked of he thought hospitals are purposely miscoding deaths, and he said no. He also said he believes there could surely be instances of the undercounting of deaths as well, not accounting for those not diagnosed, or deaths at home.
I agree these types of financial incentives are dangerous, but there is also a cost of misclassification as well - potential lawsuits and the distortion of effective COVID analysis and policy impacts can weigh just as heavy as financial incentive for many docs.
And I dont believe that hospital administrators can change COD, or dictate to a physician how to classify a death. From what I have seen firsthand, Docs have a lot of weight in the hospitals.