State of New Jersey
Executive Order #50

Governor Christine Todd Whitman

WHEREAS, fraud exists in all corners of the health marketplace and is perpetrated on and by consumers, health care facilities, practitioners, insurance companies and others. Nationally, as much as 50*billion health care dollars are lost each year to fraud in various forms, including false claims, fraudulent subcontracts, unreliable billing practices, excessive salaries, bribery, tax evasion and kickbacks; and

WHEREAS, ultimately the members of the public, as consumers and taxpayers, bear the cost of these fraudulent activities since providers and insurers shift the cost to government, employers and to those who can afford insurance, while too often the poorest members of society are left with inadequate medical services; and

WHEREAS, health care is a large and profitable business and presents a significant opportunity for financial gain in which any lack of effective regulatory and legal controls and enforcement mechanism invites fraud; and

WHEREAS, New Jersey cannot wait for the conclusion of the national dialogue to decide how best to allocate scarce health care resources, achieve access to quality care for all New Jersey citizens and rid the marketplace of fraud; and

WHEREAS, New Jersey must ensure that its regulatory and legal efforts are as strong and effective as possible in both preventing health care fraud and in identifying and prosecuting such fraud where it exists; and

WHEREAS, there have been enforcement successes in the ongoing battle against health care fraud, including the investigation and prosecution of alleged broad based schemes involving fraudulent insurance claims submitted by health care providers and others to private insurance companies, self-funded insurance programs and the Medicaid program. More, however, needs to be done; and

WHEREAS, health care fraud will be better policed by a broad "systematic" approach and greater coordination of prevention and enforcement efforts;

NOW, THEREFORE, I, CHRISTINE TODD WHITMAN, Governor of the State of New Jersey, by virtue of the authority vested in me by the Constitution and by the Statutes of this State, do hereby ORDER and DIRECT:

1. The establishment of the Health Care Fraud Task Force (the "Task Force"), which shall function as the policy development body for the Executive Branch in establishing a comprehensive health care fraud enforcement plan.

2. The Task Force shall identify and catalogue the forms of health care fraud existing within the New Jersey marketplace and identify all Executive Branch agencies and resources currently involved or which should be involved in health care fraud prevention and enforcement.

3. The Task Force shall identify priority prevention and enforcement areas, as well as design and implement coordination strategies among all Executive Branch agencies for the centralized investigation and prosecution of all civil and criminal cases involving significant or widespread fraud in the health care industry, as well as strategies for the effective handling and disposition of other cases.

4. The Task Force shall develop and recommend an Executive Branch budget for the support of a comprehensive and effective health care fraud prevention and enforcement strategy from existing resources and identify emerging technologies necessary for an effective and comprehensive strategy.

5. The Task Force shall design and implement measures (1) to educate the public and health care industry, and in particular to eliminate their tolerance of health care fraud and (2) to reduce the opportunities for individual gain through fraudulent health care practices.

6. The Task Force shall develop ongoing outreach activities with the industries and professions which make up the health care delivery system to insure that the needs and concerns of those entities are reflected in the comprehensive health care fraud enforcement plan.

7. Finally, the Task Force shall identify statutory, regulatory and administrative changes or improvements related to health care fraud prevention and enforcement.

8. The Task Force shall consist of the Attorney General, who shall serve as chairperson of the Task Force; the Treasurer; the Commissioner of Health; the Commissioner of Insurance; and the Commissioner of Human Services.

9. The Task Force shall report to me periodically regarding its progress in establishing a comprehensive health care fraud enforcement plan. The first report shall be issued no later than six months following the date of this Order, and the second report no later than one year following the date of this Order. Subsequent reports as to status of the plan shall be issued every year thereafter.

10. This Order shall take effect immediately.

GIVEN, under my hand and seal
this 28th day of May in the Year
of Our Lord, One Thousand Nine
Hundred and Ninety-Six, and of the
Independence of the United States,
the Two Hundred and Nineteenth.

/s/ Christine Todd Whitman


/s/ Harriet Derman
Chief Counsel to the Governor