N.J. Admin. Code § 13:88-3.8

Current through Register Vol. 56, No. 24, December 18, 2024

Section 13:88-3.8 - Criteria for evaluating a reward application

(a) The OIFP may pay a reward upon the arrest, prosecution, and conviction of a person or entity for health care claims fraud, insurance fraud or any other criminal offense involving or related to an insurance transaction.

(b) A person who provides information under N.J.A.C. 13:88-3.4 and submits a timely reward application form under N.J.A.C. 13:88-3.5 shall be eligible for a reward if the information:

1. Led to the arrest, prosecution and conviction of a specific individual(s) or entity(ies) for specified conduct occurring during a particular time period, as detailed in the reward program application submitted by the informant pursuant to N.J.A.C. 13:88-3.5; or

2. Directly led to the arrest, prosecution and conviction of other individuals or other entities for specified conduct occurring during a particular time period as detailed in the reward program application submitted by the informant pursuant to N.J.A.C. 13:88-3.5.

(c) The OIFP shall not grant a reward for information relating to an individual or entity that, at the time the information is provided, is already the subject of a referral to the OIFP; is already the subject of an investigation by the OIFP, either civilly or criminally; or is already the subject of an investigation by the New Jersey Department of Human Services; the New Jersey Department of Health and Senior Services; the Health Care Financing Agency and the Office of the Inspector General; the New Jersey Department of Banking and Insurance; the New Jersey Division of Consumer Affairs or its licensing boards; or any other Federal, State, county or municipal agency.

N.J. Admin. Code § 13:88-3.8

Amended by R.2009 d.354, effective 12/7/2009.
See: 41 N.J.R. 2630(a), 41 N.J.R. 4454(a).
In (c), substituted "Division" for "Department" preceding and "or" for "and" following "of Consumer Affairs".