This article appeared in the Daily Business Review on October 28, 2025.
Commentary provided by Jennifer J. Perez.
Florida practitioners: Are you thinking of holding on to patient overpayments? Think again. The Florida Legislature has passed CS/CS/SB 1808, which goes into effect on January 1, 2026, introducing new requirements for licensed healthcare providers and facilities with regard to how and when they must return overpayments to patients. Namely, licensed practitioners and establishments are now required to refund any overpayments made by patients within 30 days of the licensee determining that an overpayment was made by the patient.
This applies to those licensed by way of (1) Chapter 456, F.S. governing Health Professions and Occupations and (2) the Agency for Health Care Administration (AHCA), and thus has been codified in Section 456.0625 and Section 408.12 of the Florida Statutes.
Additionally, this new law only applies to overpayments owed to a patient when the licensed provider has submitted charges for reimbursement with a government-sponsored health care program (such as Medicare or Medicaid) or a private health insurer or health maintenance organization (HMO) for services rendered to that patient. This thus excludes instances where the patient overpaid for services that were not billed to any such insurer, such as self-pay visits and procedures not covered by insurance.
The Department of Health (“DOH”) or applicable licensing board can impose disciplinary actions (i.e., fines and/or suspension, restriction or revocation of licensure) against the licensed practitioner who does not comply. The very last issue a busy practitioner needs is to be blindsided by a restriction or worse, a revocation of his or her license, which would not only halt his or her ability to practice medicine—it could also permanently tarnish his or professional reputation.
Furthermore, the law authorizes AHCA to impose a fine of up to $500 per violation by AHCA licensees. According to Section 408.813 of the Florida Statutes, “each day of violation constitutes a separate violation and is subject to a separate fine.” Very expensive fines can therefore accumulate quickly.
Specifically not addressed (yet), is what constitutes determination that an overpayment has been made. This may spark discussions and comments in the coming months, since deeming an overpayment was made by a patient is what starts the 30-day clock running. Several factors may need to be considered in making this determination. These could include the date the payment was posted, the date the account was reconciled, the date any internal compliance reviews flagged the discrepancy, or any combination of these factors. Additionally, system-generated and automated alerts or notes in the patient’s financial record can serve as evidence of the determination date. In cases where third-party vendors are responsible for billing, payment posting or account reconciliation, delays or errors on their part can significantly impact when an overpayment is actually identified versus when it actually occurred. Software glitches, system lags, miscommunication, vendor internal processing issues or incorrect posting practices by vendors may result in delayed or even failed recognition of an overpayment. Managing all of these factors in an efficient way will be crucial. Practitioners should take a hard look at internal compliance policies and procedures, as well as agreements with third-party vendors to ensure proper protections are in place. In particular, providers should ensure that vendors are contractually obligated to meet accuracy and timeliness standards and are regularly monitored for performance. Are vendors being held to strict, measurable service level standards? Are they delivering on these standards? If no, is the vendor agreement terminable and are there other vetted, alternate vendors that can do the job? These are just a few inquiries providers should be making when assessing this critical component of this new law.
These laws are set to go into effect January 1, 2026. Florida billing staffs, compliance officers and financial administrators must understand these changes and effectively implement them to ensure compliance. Additionally, patient intake forms and financial policies should be revised to reflect these changes and properly protect providers. Being proactive rather than reactive not only minimizes financial penalties but also protects the provider’s license and professional reputation. While it is not clear how the Florida government will ultimately enforce these new laws, it now has a legislature-backed path through which to navigate such enforcement.
For more information and further details around this law, as well as other healthcare related legal issues, please contact Jennifer J. Perez, Esq. at jperez@shutts.com.