New Florida Law: Patient Overpayments Must Be Refunded Within 30 Days
Client Alert
Effective January 1, 2026, Florida Senate Bill 1808, will require health care facility licensees and health care practitioners to refund overpayments made by patients within 30 days after determination that an overpayment was made. Failure to timely refund overpayments may result in fines or disciplinary actions.
Who does SB 1808 apply to?
The law will apply to health care facility licensees that are licensed by the Florida Agency for Health Care Administration and health care practitioners licensed by the Florida Department of Health. Billing departments, management companies, or group practices that accept payment for services rendered by a practitioner are also required to follow the 30-day refund mandate.
What overpayments are subject to this mandate?
The new law will only apply to overpayments owed to a patient when the provider has submitted charges for reimbursement with (1) a government-sponsored health care program (such as Medicaid or Medicare) or (2) a private health insurer or health maintenance organization for services rendered to a patient. This would exclude instances where a patient overpaid for services that were not billed to any insurer (for example, if the patient self-paid for a procedure not covered by insurance). Additionally, this does not apply to overpayments made by a health insurer or health maintenance organization.
What starts the 30-day clock to issue a refund?
Licensees and practitioners have 30 days to issue a refund from the date they determine that a patient made an overpayment. This places the responsibility to check payment records to determine any overpayments on the licensees and practitioners.
What happens if a refund is not issued within 30 days after overpayment is determined?
For health care facility licensees, failure to timely issue a refund could result in administrative fines. Fines range to up to $500 per violation and each day a refund is late constitutes a separate violation that is subject to an additional fine.
For health care practitioners, failure to timely issue a refund will now be grounds for a disciplinary action with the Florida Department of Health. Health care practitioners may also be subject to discipline if their billing department, management company, or group practice who accepts payment on their behalf fails to issue a timely refund.
Best Practices
To ensure compliance with SB 1808, health care facilities and practitioners should review payment policies and billing practices to assist in identifying any potential overpayments and providing mechanisms for timely issuing refunds as needed.
To learn more about this new law and ensuring compliance, please contact BMD Healthcare Member Amanda Waesch at alwaesch@bmdllc.com.