N.J. Admin. Code § 13:88-3.9

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

Section 13:88-3.9 - Determination and notification of eligibility for reward

(a) Upon the conviction of persons or entities who have committed health care claims fraud, insurance fraud or any other criminal offense related to an insurance transaction, the OIFP shall notify the applicant within 90 days of the conviction as to the OIFP's determination of the eligibility of the applicant for the reward.

(b) Written notification shall contain the specific reasons for a determination and inform the applicant that:

1. There is insufficient causal relationship between the information provided and the arrest, prosecution and conviction of the individuals or entities named in the matter and the applicant is not eligible for a reward;

2. The information provided proximately resulted in the arrest, prosecution and conviction of the individuals or entities named in the matter and the applicant is eligible for a reward; or

3. There is a need for further examination of the application necessitating a written response and/or personal appearance of the applicant for further information before a determination as to eligibility can be made.

N.J. Admin. Code § 13:88-3.9