Florida Senate - 2025                                     SB 944
       
       
        
       By Senator Davis
       
       
       
       
       
       5-00824-25                                             2025944__
    1                        A bill to be entitled                      
    2         An act relating to insurance overpayment claims
    3         submitted to psychologists; amending s. 627.6131,
    4         F.S.; revising a definition; requiring that insurance
    5         overpayment claims submitted to psychologists be
    6         submitted within a specified timeframe; providing
    7         applicability; providing an effective date.
    8          
    9  Be It Enacted by the Legislature of the State of Florida:
   10  
   11         Section 1. Subsections (2) and (18) of section 627.6131,
   12  Florida Statutes, are amended to read:
   13         627.6131 Payment of claims.—
   14         (2) As used in this section, except where the context
   15  clearly indicates otherwise, the term “claim” for a
   16  noninstitutional provider means a paper or electronic billing
   17  instrument submitted to the insurer’s designated location that
   18  consists of the HCFA 1500 data set, or its successor, that has
   19  all mandatory entries for a physician licensed under chapter
   20  458, chapter 459, chapter 460, chapter 461, or chapter 463, or
   21  psychologists licensed under chapter 490 or any appropriate
   22  billing instrument that has all mandatory entries for any other
   23  noninstitutional provider. For institutional providers, “claim”
   24  means a paper or electronic billing instrument submitted to the
   25  insurer’s designated location that consists of the UB-92 data
   26  set or its successor with entries stated as mandatory by the
   27  National Uniform Billing Committee.
   28         (18) Notwithstanding the 30-month period provided in
   29  subsection (6), all claims for overpayment submitted to a
   30  provider licensed under chapter 458, chapter 459, chapter 460,
   31  chapter 461, or chapter 466, or chapter 490 must be submitted to
   32  the provider within 12 months after the health insurer’s payment
   33  of the claim. A claim for overpayment may not be permitted
   34  beyond 12 months after the health insurer’s payment of a claim,
   35  except that claims for overpayment may be sought beyond that
   36  time from providers convicted of fraud pursuant to s. 817.234.
   37         Section 2. The amendments made by this act to s.
   38  627.6131(18), Florida Statutes, apply to claims for services
   39  provided on or after October 1, 2025.
   40         Section 3. This act shall take effect July 1, 2025.