STORAGE NAME: h0839.IBS
DATE: 3/12/2025
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FLORIDA HOUSE OF REPRESENTATIVES
BILL ANALYSIS
This bill analysis was prepared by nonpartisan committee staff and does not constitute an official statement of legislative intent.
BILL #: HB 839
TITLE: Insurance Overpayment Claims Submitted to
Psychologists
SPONSOR(S): Booth
COMPANION BILL: None
LINKED BILLS: None
RELATED BILLS: SB 944 (Davis)
Committee References
Insurance & Banking
Health Care Facilities & Systems
Commerce
SUMMARY
Effect of the Bill:
By default, under Florida law, health insurers have 30 months after rendering payment to a provider to submit a
claim for overpayment. The bill reduces the 30-month period to 12 months for overpayment claims submitted to
licensed psychologists provided on or after January 1, 2026.
The bill adds licensed psychologists to a list of providers that already enjoy the shortened overpayment claim
window under Florida law. Existing law applies the 12-month period for overpayment claims to several licensed
providers (chiropractors, podiatrists, osteopaths, certain physicians and dental surgeons).
Fiscal or Economic Impact:
Insurers may recover less from overpaid claims to psychologists due to the reduced overpayment claim period. The
effect on premiums is indeterminate.
JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
ANALYSIS
EFFECT OF THE BILL:
The bill adds psychiatrists licensed under ch. 490, F.S., to a list of licensed providers that enjoy a reduced time
period for insurers to submit claims for overpayment. Under the reduced time period, claims for overpayment
must be submitted to the provider within 12 months, rather than the standard 30-month period.
The changes in the bill apply to claims for services provided on or after January 1, 2026.
FISCAL OR ECONOMIC IMPACT:
PRIVATE SECTOR:
Insurers may recover less from overpaid claims to psychologists due to the reduced overpayment claim period.
The effect on premiums is indeterminate.
RELEVANT INFORMATION
SUBJECT OVERVIEW:
Health Insurer Review of Claims Overpayment
Subsection (6) of s. 627.6131, F.S., contains the process by which a health insurer may make a claim for
overpayment against a provider to whom it rendered payment. The insurer must send a written or electronic
statement specifying the basis for the retroactive denial or payment adjustment to the provider of the specific JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
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provider claim(s) for which the overpayment is submitted. Often, overpayment claims are the result of a
retroactive review or audit of coverage decisions and payment levels.
If the overpayment is not related to fraud, the health insurer must submit its claim for overpayment within 30
months after the insurer paid the claim. After receiving the claim for overpayment, the provider has 40 days in
which to pay, deny, or contest the claim. A contested claim for overpayment must be paid or denied by the provider
within 120 days after receipt. If, after 140 days, the provider has not paid or denied the overpayment claim, an
uncontestable obligation is placed on the provider to pay the insurer’s claim. A provider that chooses to deny or
contest an insurer’s claim must notify the insurer in writing of the provider’s decision within 35 days after the
provider received the claim for overpayment. If the claim is contested, the provider must request additional
information, which the insurer has 35 days to give the provider after receiving the request. After receiving the
additional information, the provider has 45 days to pay or deny the claim.
Subsection (18) of s. 627.6131, F.S., provides an exception. Claims for overpayment must be submitted within 12
months, rather than the usual 30-month period, to certain providers. Specifically, the exception applies to
overpayment claims submitted to physicians licensed under ch. 458, F.S., osteopaths licensed under ch. 459, F.S.,
chiropractors licensed under ch. 460, F.S., podiatrists licensed under ch. 461, F.S., and (for oral surgery only) dental
surgeons licensed under ch. 466, F.S.
BILL HISTORY
COMMITTEE REFERENCE ACTION DATE
STAFF
DIRECTOR/
POLICY CHIEF
ANALYSIS
PREPARED BY
Insurance & Banking
Subcommittee
Lloyd Schenk
Health Care Facilities & Systems
Subcommittee
Commerce Committee