Florida's Patient Brokering Act for Providers and Their Vendors

Florida passed its Patient Brokering Act in 1996, two decades before Congress wrote EKRA, and it remains the broader of the two. Fla. Stat. 817.505 applies to "any person, including any health care provider or health care facility," regardless of who pays for care. For substance abuse service providers licensed by DCF under chapter 397, it sits beside the state's licensing law and its recovery residence referral rule. Together they set the terms for every arrangement a Florida program has with marketers, consultants, sober homes and other providers. What follows is a plain reading for compliance readiness, not legal advice.

What does the Act prohibit?

Section 817.505(1) makes it unlawful to:

1. offer or pay a commission, benefit, bonus, rebate, kickback or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, "in any form whatsoever, to induce the referral of a patient or patronage to or from a health care provider or health care facility";
2. solicit or receive any of those in return for referring a patient or patronage to or from a provider or facility;
3. solicit or receive any of those "in return for the acceptance or acknowledgment of treatment" from a provider or facility; or
4. "aid, abet, advise, or otherwise participate in" any of that conduct.

Two features matter most. Referrals run "to or from" a provider, so a program paying for people it receives and a program paid for people it sends are both covered. And the fourth clause reaches advisers: a consultant who designs or recommends a split-fee arrangement can commit the offense without ever paying or receiving a dollar.

Who counts as a health care provider or facility?

The definition in 817.505(2)(a) is wide. It includes anyone licensed, certified or registered with, or required to be or lawfully exempt from being licensed by, the Agency for Health Care Administration or the Department of Health; Medicaid contractors under 409.907; county health departments; community service providers contracting with DCF for alcohol, drug abuse or mental health services; "any substance abuse service provider licensed under chapter 397"; and federally supported primary care programs. Every licensed Florida treatment program is inside it.

What are the exceptions?

Section 817.505(3) lists them. The ones treatment providers ask about most are:

• Anything the federal Anti-Kickback Statute does not prohibit (3)(a): any discount, payment, waiver of payment or payment practice not prohibited by 42 U.S.C. 1320a-7b(b) or its regulations. This is why federal safe harbors matter in Florida even for privately insured care.
• Payments for professional consultation services to a health care provider or facility (3)(c).
• Health plan and network payments for goods or services under a health benefit plan (3)(e) and (f).
• Information services, under strict conditions (3)(i). A provider may pay a service that gives consumers information about providers on request and free of charge only if the service does not steer consumers toward a particular provider, does not present itself as offering diagnosis, counseling or assessments or make promises of cure, does not provide or arrange transportation to or from a provider, and charges fees "set in advance" and "consistent with the fair market value" that are "not based on the potential value of a patient or patients" to the provider.

That last exception reads like a checklist of what a lawful directory looks like, and by implication of what a referral service that charges by the head looks like.

How severe are the penalties?

A violation is a third-degree felony with a mandatory $50,000 fine. If the conduct involves 10 to 19 patients, it is a second-degree felony with a $100,000 fine; 20 or more patients, a first-degree felony with a $500,000 fine (817.505(4)). The penalty sections apply to "any person, including an officer, partner, agent, attorney, or other representative" of a business entity, and the statute says its remedies are in addition to any others and may be imposed "against both corporate and individual defendants" (817.505(7)). The Attorney General or a state attorney can also seek an injunction and recover investigative and legal costs (817.505(5) and (6)).

How does the recovery residence referral rule fit?

It adds a licensing-law layer on top of the criminal statute. A DCF-licensed service provider "may not make a referral of a prospective, current, or discharged patient to, or accept a referral of such a patient from, a recovery residence" unless the residence holds a valid certificate of compliance and is actively managed by a certified recovery residence administrator (Fla. Stat. 397.4873(1)). A referral includes informing a patient "by any means about the name, address, or other details of a recovery residence." Separately, no referral may go to or come from a residence that allows alcohol, marijuana, illegal drugs or someone else's prescription medications on its premises (397.4873(3)).

A willful and knowing violation is a first-degree misdemeanor, and a licensed provider faces an administrative fine of $1,000 per occurrence (397.4873(5) and (7)). Providers must keep records of referrals to and from recovery residences as DCF prescribes (397.4873(6)), and the license application itself must name every recovery residence the provider plans to refer patients to or accept patients from (397.403(1)(j)). Certification of a residence does not make paying it for residents lawful; 817.505 still applies. More in Florida's recovery residence certification and the referral rule.

Which arrangements deserve a second look?

• A marketing vendor, call center or "placement" service paid by the caller, intake or enrollment.
• A sober home that pays the program, or that the program pays, in any way connected to who moves between them.
• A consultant compensated as a share of revenue from the people a relationship produces.
• A directory or referral line that steers callers, offers rides, or prices its listing by the value of the patients it sends.
• Waived copays or other benefits offered to patients to induce them to choose the program.

Federal law applies too. EKRA makes paying or receiving remuneration for referrals to recovery homes and clinical treatment facilities a federal crime across all payers, and it does not displace Florida's statute; see EKRA and treatment centers.

Where do licensing and compliance work fit?

Licensing does not make a referral arrangement lawful, but it does create the paper trail regulators read. Operating as a substance abuse service provider without a license or exemption is itself a third-degree felony in Florida (Fla. Stat. 397.401). A clean license file, a recovery residence list that matches practice, referral records DCF can audit and a written policy on marketing and referral relationships are the basics. See Florida's DCF substance abuse provider license and the Florida page.

White Glove Behavioral does compliance work only, for flat published fees that never depend on admissions, referrals, census, revenue or outcomes. We do not market treatment, refer to or rank sober homes, or connect programs with anyone who does. Our Florida outpatient license package is $1,995 for one site, residential $2,995, and a Policy and Procedure Manual ($1,495) can include a referral and marketing policy written to 817.505, 397.4873 and EKRA, as policy readiness for your counsel to review.