MIAMI — Florida Gov. Ron DeSantis called on the state attorney general Friday to investigate a South Florida hospital charging $150 per test for COVID-19, the disease caused by the novel coronavirus spreading rapidly across the state.
While DeSantis did not name the hospital, Larkin Community Hospital opened a drive-thru testing site in Hialeah on March 20 and charges $150 per test.
“We’ve seen reports of a hospital in the city of Hialeah and Miami-Dade that’s charging individuals $150 to get tested for COVID-19,” DeSantis said in a news conference. “That’s not acceptable here in the state of Florida. The president has made clear… the tests are free. … I’m going to ask Attorney General (Ashley) Moody to immediately investigate this hospital.”
Jack Michel, a physician and CEO of Larkin, said he was “shocked” to hear about the governor’s statement. Larkin’s drive-thru site opened on March 20 and has tested more than 1,000 people.
“I’m not sure what that’s about,” Michel said, adding that Larkin’s lab has been running the drive-thru site and deserves to get paid similar to commercial labs, such as LabCorp and Quest, that have contracted with the Florida Department of Health to process COVID-19 tests.
Other drive-thru testing sites in South Florida operated by the state emergency management office and regional hospitals offer COVID-19 testing free of charge.
Two days after Larkin’s testing site opened, Michel took to his Facebook account to sound an alarm about what he was seeing based on the tests his company is doing. The post has been shared by more than 6,500 Facebook users.
“We are seeing a significant amount of virus infection,” Michel said in the Facebook post. “After reviewing their recent contacts, we can independently confirm that we have concrete evidence of community spread in our area of COVID-19. … We can conservatively assume that more than 50% of our local population will be infected with COVID-19 in the next few weeks.”
Michel pushed back against critics who called his Facebook post alarmist, and accused him of drumming up demand for testing.
“Of course, they say it’s bad intentions,” he told The Miami Herald. “And when we have several hundred deaths, I want to see where those people are going to be.”
Doctors often consider the cost of treatment when providing care to patients, said Kenneth Goodman, a medical ethicist and founder and director of the University of Miami Miller School of Medicine’s Institute for Bioethics and Health Policy.
“But that doesn’t mean anything goes,” Goodman said. “We are in what is probably the worst public health emergency in a century. Now is not the time to work the angles.”
It’s not clear how much Larkin is profiting from the drive-thru site, which is staffed by the hospital’s nurses.
The Medicare reimbursement rate for a COVID-19 test is about $50. Most private health insurers have said they will cover testing for COVID-19 at no cost to the patient.
For seniors age 65 and older with Medicare, testing is covered with no cost sharing when it is ordered by a doctor or another healthcare provider that accepts Medicare, and if the test was ordered after Feb. 4, 2020. Recently-passed legislation also eliminates cost sharing for testing-related services, such as a related visit to the doctor or a hospital emergency room.
Larkin’s testing site began by testing only police, firemen, healthcare workers and certain staff for the cities of Hialeah and Miami. But after the first day, Michel said he expanded testing eligibility to include the general public.
Other drive-thru sites, including ones at Marlins Park in Little Havana, focus testing on the elderly population, since those 65 and older with chronic medical conditions are more at risk for severe symptoms or death from COVID-19. A drive-thru site at Hard Rock Stadium in Miami Gardens also prioritizes seniors and first responders.
Guidelines published the Centers for Disease Control and Prevention advise doctors to conserve COVID-19 tests, which are in limited supply, by prioritizing hospitalized patients and symptomatic healthcare workers first, followed by patients in long-term care facilities such as nursing homes, and persons age 65 and older with symptoms.
Michel said first responders and healthcare workers still get prioritized for testing, but anyone regardless of age can sign up for a COVID-19 test by registering through a website, where users input their personal information and self-attest to having symptoms, including fever, cough and difficulty breathing.
Michel, a licensed Florida doctor, said he signs off on every online registration that meets those criteria. Asymptomatic persons are not tested, Michel said. But, “if you have one of those three (symptoms), then you pay. You go to PayPal,” he said, when explaining the online sign-up process.
As of Friday morning, Larkin’s drive-thru site had tested 1,008 people, including 125 who came back positive for COVID-19, he said.
Michel said one person tested through the drive-thru site is a nurse at a hospital ICU whose employer would not provide testing even though she had a cough and a fever.
“She went home because she was really tired, and decided to pay herself to find out and went to the drive-thru,” he said. “Who knows how many people were in that ICU or hospital. … That’s the type of stuff we’re seeing, and that’s what’s worrying me. Our system is not prepared for things like this.”
Michel is also the owner of a Hollywood Hills nursing home where 12 residents died after the facility lost power to its air conditioning unit because of Hurricane Irma in September 2017. He said knows how healthcare providers can be blamed for failing patients after a disaster or emergency.
State regulators shut down the nursing home after the patients’ deaths, and then stripped the nursing home of its Medicaid license. In August of last year, Hollywood police arrested the nursing home’s administrator and three workers, charging them with aggravated manslaughter and tampering with medical records. Michel was not charged.
Other South Florida hospitals cooperating with state and local officials to run drive-thru testing sites or operating their own offer testing free of charge.
Jackson Health System, Miami-Dade’s safety net hospital, is helping with the drive-thru site at Marlins Park. Memorial Healthcare System, the public hospital for South Broward, is working the Florida National Guard and the state’s emergency management office to run a site at CB Smith Park in Pembroke Pines.
In Pompano Beach, Broward Health, the public hospital for North Broward, also ran a drive-thru site, but had to close it after five days because the hospital had run out of swabs and other supplies, said Jennifer Smith, a spokeswoman.
“Demand was such that we’re actively working to get more supplies,” Smith said. “We understand the demand and the need for it.”
Michel also understands the demand for COVID-19. When he announced the opening of the drive-thru site in Hialeah, Michel said he planned to ramp up testing capacity by the first week of April. He said Larkin owns a testing machine capable of running about 1,000 tests a day, but the hospital does not have enough reagent — a mixture needed to process tests.
Florida Surgeon General Scott Rivkees contacted the manufacturer on Larkin’s behalf to make more re-agent available, Michel said last week. He expects to receive a shipment soon.
On Thursday, Michel announced that Larkin was starting an online fundraiser to help persons who cannot afford the $150 per test by matching contributions dollar for dollar to pay for 1,000 tests. As of Friday, though, the online campaign had not yet started.
“We will be posting the link when it’s available,” Michel said in a text message.
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(Staff writer Ben Conarck contributed to this report.)
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