Title: Refund of Overpayments Made by Patients

Summary: Requires certain licensees & practitioners to refund to patient any overpayment within specified timeframe; authorizes AHCA to impose administrative fine for failure to refund patient overpayment; revises acts that constitute grounds for disciplinary actions for health care practitioners.

Full Text:
An act relating to refund of overpayments made by patients; creating ss. 408.12 and 456.0625, F.S.; requiring certain licensees and practitioners to refund to a patient any overpayment within a specified timeframe; defining the term "tenders charges for reimbursement"; providing applicability; providing penalties; amending s. 408.813, F.S.; authorizing the Agency for Health Care Administration to impos ean administrative fine for failure to refund a patient overpayment; amending s. 456.072, F.S.; revising acts that constitute grounds for disciplinary actions for health care practitioners; providing an effective date. Be It Enacted by the Legislatur eof the State of Florida: Section 1. Section 408.12, Florida Statutes, is created to read: 408.12 Patient overpayments; refunds.-(1) A licensee who tenders charges for reimbursement shall refund to the patient the amount of any overpayment made by the patient to the licensee no later than days after the date that the licensee determines that such overpayment was made. For purposes of this section, the term "tenders charges for CS/HB 1513 2025 reimbursement" means the licensee files a claim for reimbursement with any government-sponsored program or private health insurer or health maintenance organization for services rendered to the patient. (2) This section does not apply to an overpayment subject to s. 627.6131 or s. 641.3155. (3) A licensee who violates this section is subject to an administrative fine under s. 408.813. Section 2. Paragraph (g) is added to subsection (3) of section 408.813, Florida Statutes, to read: 408.813 Administrative fines; violations.-As a penalty for any violation of this part, authorizing statutes, or applicable rules, the agency may impose an administrative fine. (3) The agency may impose an administrative fine for a violation that is not designated as a class I, class II, class III, or class IV violation. Unless otherwi se specified by law, the amount of the fine may not exceed $500 for each violation. Unclassified violations include: (g) Failing to refund a patient overpayment pursuant to s. 408.12. Section 3. Section 456.0625, Florida Statutes, is created to read: 456.0625 Patient overpayments; refunds.-(1) A health care practitioner who tenders charges for reimbursement, or any billing department, management company, or CS/HB 1513 2025 group practice that accepts payment for services rendered by the health care practitioner, shall refund to the patient the amount of any overpayment made by the patient no later than days after the date that it was determined that an overpayment was made. For purposes of this section, the term "tenders charges for reimbursement" means the he alth care practitioner, department, company, or practice files a claim for reimbursement with any government-sponsored program or private health insurer or health maintenance organization for services rendered by the health care practitioner to the patient.(2) This section does not apply to an overpayment subject to s. 627.6131 or s. 641.3155. (3) A health care practitioner's violation of this section constitutes grounds for disciplinary action under s. 456.072. Section 4. Paragraph (tt) is added to subsection (1) of section 456.072, Florida Statutes, to read: 456.072 Grounds for discipline; penalties; enforcement.-(1) The following acts shall constitute grounds for which the disciplinary actions specified i nsubsection (2) may be taken: (tt) Failure to comply with s. 456.0625, relating to refunding overpayments to patients. Section 5. This act shall take effect January 1, 2026.