N.Y. Comp. Codes R. & Regs. tit. 9 § 5.37
WHEREAS, the provision of health care and the insurance reimbursement thereof directly and indirectly affect many sectors of the public, business and government. The many facets of the business of insurance -- the organization and licensing of providers, the issuance of policies, the payment of claims and the provision of health care services to customers -- consist of numerous transactions which have the potential for abuse and illegal activities. Each year, unscrupulous health care providers, illegitimate claimants and other individuals cheat insurance companies out of billions of dollars; and
WHEREAS, the General Accounting Office of the United States Government has estimated that approximately 10 percent of the more than 700 billion dollars in health care costs nationwide is attributable to health insurance fraud and abuse, making this a national problem of epic proportions; and
WHEREAS, the cost of health care coverage has risen sharply throughout the nation as well as in New York in recent years due in part to the increase in incidents of this abuse and these illegal activities otherwise known as "insurance fraud"; and
WHEREAS, the problem of insurance fraud in the health care insurance industry is increasing in frequency and scope, resulting in a deluge of reports of health care insurance fraud to the Insurance Frauds Bureau of the New York State Insurance Department. The Bureau received 789 health insurance related fraud reports in 1991, while in 1995 the Bureau received nearly ten thousand (10,000) health insurance-related fraud reports -- an increase of over 1200% during a four-year period. The Bureau also in 1995 reported its highest number of arrests in this area in its fourteen year history; and
WHEREAS, the problem of health care insurance fraud costs the citizens of this state billions of dollars each year in higher premiums and endangers each citizen's access to quality affordable health care; and
WHEREAS, the nature of the health care insurance industry presents a unique and difficult law enforcement problem. The existence of a vast number of health care providers enables unscrupulous individuals to quickly change the focus of their scams between the many different providers -- often between public and private providers -- allowing them to keep one step ahead of investigators. This insidious aspect of health care insurance fraud highlights the need for a multi-agency coordinated approach by the government of New York State; and
WHEREAS, the problem of health care insurance fraud is pervasive, and, although state officials currently perform their duties in combating this severe public problem in an outstanding manner, it is necessary now to unite the expertise and experience of all agencies and departments which currently carry on the battle individually into a coordinated effort to attach this critical public problem;
NOW, THEREFORE, I, GEORGE E. PATAKI, Governor of the State of New York, by virtue of the authority vested in me by the Constitution and Laws of the State of New York, do hereby order as follows:
There is hereby established the Joint Task Force on Health Care Insurance Fraud for the purpose of conducting coordinated investigations into and prosecution of health care insurance fraud in New York State. The Task Force shall consist of a representative appointed by each of the following persons: the Attorney General, the Superintendent of Insurance, the Commissioner of Health, the Commissioner of Social Services, the Commissioner of Labor, the Chairman of the Workers' Compensation Board and the Director of Criminal Justice and Commissioner of the Division of Criminal Justice Services. The members appointed by the Attorney General and the Superintendent of Insurance, respectively, shall be the Co-Chairs of the Task Force. Members of the Task Force shall receive no compensation but shall be entitled to reimbursement for any necessary expenses incurred in connection with the performance of their duties.
The Joint Task Force on Health Care Insurance Fraud shall be a united multi-agency effort to investigate instances of health care insurance related fraud and abuse and to bring responsible persons and companies to justice. The Joint Task Force on Health Care Insurance Fraud shall be located within the Office of the Attorney General of the State of New York.
The departments, agencies and Board represented on this Joint Task Force shall cooperate fully with said Task Force and its mission and shall provide, in addition to appointed representatives, health care fraud investigators, prosecutors, and all necessary support staff. The investigators, prosecutors, and support staff shall be provided to the members of the Joint Task Force as the same are determined to be necessary to fulfill the purpose stated herein after consultation between the Joint Task Force and its member departments, agencies, and Board. All investigators provisioned to the Joint Task Force by its members shall be considered investigators for the office of the Attorney General, having such powers and responsibilities commensurate with all other investigators of that office.
Signed: George E. PatakiDated: May 3, 1996
[FN[DAGGER]] [Revoked by Executive Order No. 9 (David A. Paterson), infra.]
[Revoked by Executive Order No. 2 (Andrew M. Cuomo), infra.]
N.Y. Comp. Codes R. & Regs. Tit. 9 § 5.37