Charity Care Fraud and Abuse

January 16, 2018

Anthony Santora
MuckRock News
DEPT MR 47644
411A Highland Ave
Somerville, MA 02144-2516

Re: OPRA Request Received on January 15, 2018

Dear Mr. Santora:

The Office of the State Comptroller (OSC) received your Open Public Records Act (OPRA) request on January 15, 2018. As such, the seven (7) business day deadline to respond to your request is January 24, 2018. This response is being provided to you on January 16, 2018, the first business day after the custodian's receipt of said request.

Your OPRA request sought access to the following documents:

"(1) Documents and records sufficient as to fully identify the total number of Charity Care fraud, waste or abuse investigations and/or audits conducted between 2013 through 2017.
(2) Documents and records sufficient as to fully identify the total number of referrals or complaints received related to Charity Care fraud, waste or abuse between 2013 through 2017.
(3) Documents and records sufficient as to fully identify the total dollar amount of recoveries made on cases related to Charity Care fraud, waste or abuse between 2013 through 2017.
(4) Documents and records sufficient as to fully identify the total number of Charity Care fraud, waste or abuse investigations that were referred for criminal prosecution to a local or county prosecutor/district attorney or the state Attorney General between 2013 and 2017.
(5) Documents and records sufficient as to fully identify policies, procedures, guidelines or directives related to Charity Care fraud, waste or abuse investigations and/or audits."
Please be advised that your request is improper and overbroad because it would require the custodian to review records and perform analysis in determining whether or not particular "documents and records are sufficient" to establish certain statistical information and other matters related to each of your sub-requests. Government agencies are required to disclose only identifiable government records that are specifically described in the request. An OPRA request must identify the specific document sought; it may not request data, information or statistics. Bent v. Township of Stafford, 381 N.J. Super. 30, 37 (App. Div. 2005). Broad requests for "all" records or "any and all records" or that require a wholesale search of records maintained in various media are not encompassed by OPRA. Spectraserv, Inc. v. Middlesex County Utilities Auth., 416 N.J. Super. 565, 578 (App. Div. 2010); Gannett N.J. Partners L.P. v. County of Middlesex, 379 N.J. Super. 205, 212-13 (App. Div. 2005). Your request falls within this category. Neither OPRA nor the common law countenances open-ended searches of agency files. Spectraserv, 416 N.J. Super. 576; MAG Entertainment, LLC v. Div. of Alcoholic Bev Control, 375 N.J. Super. 534, 549 (App. Div. 2005). Nor do the laws permit a blanket request for every document an agency has on file on a topic. Spectraserv, 416 N.J. Super. at 576-78; Bent, 381 N.J. Super. at 37. Here, your request is a blanket request for every document related to the subject matter of your sub-requests which is clearly an improper request. For this reason, your request is denied.

In addition to the reason for denial set forth above, OSC reserves the right to supplement the reason with any additional basis for exception to public access as may hereinafter also be determined to apply

Very truly yours,

Robert Shane
Records Custodian

The information contained in this communication (e-mail message and/or attachments) from the Office of the State Comptroller may be legally privileged and/or confidential. If you are not the intended recipient of this transmission and have received this communication in error, do not review, transmit, copy, convert, use, disseminate or distribute the information in this e-mail or any attachments. Instead, please delete this transmission and notify the Office of the State Comptroller immediately by phone at (609) 984-2888.

Office of the State Comptroller
OPRA Office
P.O. Box 024
Trenton, NJ 08625

January 15, 2018

To Whom It May Concern:

Pursuant to Open Public Records Act ("OPRA"), I hereby request the following records:

(1) Documents and records sufficient as to fully identify the total number of Charity Care fraud, waste or abuse investigations and/or audits conducted between 2013 through 2017.
(2) Documents and records sufficient as to fully identify the total number of referrals or complaints received related to Charity Care fraud, waste or abuse between 2013 through 2017.
(3) Documents and records sufficient as to fully identify the total dollar amount of recoveries made on cases related to Charity Care fraud, waste or abuse between 2013 through 2017.
(4) Documents and records sufficient as to fully identify the total number of Charity Care fraud, waste or abuse investigations that were referred for criminal prosecution to a local or county prosecutor/district attorney or the state Attorney General between 2013 and 2017.
(5) Documents and records sufficient as to fully identify policies, procedures, guidelines or directives related to Charity Care fraud, waste or abuse investigations and/or audits.

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 7 business days, as the statute requires.

Sincerely,

Anthony Santora

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For mailed responses, please address (see note):
MuckRock News
DEPT MR 47644
411A Highland Ave
Somerville, MA 02144-2516

PLEASE NOTE: This request is not filed by a MuckRock staff member, but is being sent through MuckRock by the above in order to better track, share, and manage public records requests. Also note that improperly addressed (i.e., with the requester's name rather than "MuckRock News" and the department number) requests might be returned as undeliverable.

January 23, 2018

Dear Mr. Santora:

Thank you for attempting to further clarify your request initially received by the Office of the State Comptroller on January 15, 2018. As you know, OSC previously denied your request as "improper and overbroad" under OPRA in its e-mail response to you below dated January 16, 2018.

You clarifying request seeks the following documents:

"(1) Spreadsheets or Case Indexes or Reports that are maintained and/or used to identify the total number of Charity Care fraud, waste or abuse investigations and/or audits conducted between 2013 through 2017.

(2) Spreadsheets or Case Indexes or Reports that are maintained and/or used identify the total number of referrals or complaints received related to Charity Care fraud, waste or abuse between 2013 through 2017.

(3) Spreadsheets or Case Indexes or Reports that are maintained and/or used to identify the total dollar amount of recoveries made on cases related to Charity Care fraud, waste or abuse between 2013 through 2017.

(4) Spreadsheets or Case Indexes or Reports that are maintained and/or used to identify the total number of Charity Care fraud, waste or abuse investigations that were referred for criminal prosecution to a local or county prosecutor/district attorney or the state Attorney General between 2013 and 2017.

(5) Copies of policies, procedures, guidelines or directives maintained and/or used for Charity Care fraud, waste or abuse investigations and/or audits."

Please be advised that with regard to requests #1 through #4, OSC does not maintain any such "spreadsheets or case indexes or reports" specific to Charity Care fraud matters. Thus, in order to fulfill this request, OSC would be required to manually search five (5) years of records to identify any matters, referrals, complaints or recoveries that may be fairly categorized as Charity Care fraud and then create new records concerning the results of those searches. As such, your clarifying requests are still overbroad and improper under OPRA. See MAG Entertainment, LLC v. Div. of Alcoholic Bev Control, 375 N.J. Super. 534, 549 (App. Div. 2005); Bent v. Township of Stafford, 381 N.J. Super. 30, 37 (App. Div. 2005); Spectraserv, Inc. v. Middlesex County Utilities Auth., 416 N.J. Super. 565, 578 (App. Div. 2010).

With regard to request #5, OSC does not utilize any such policies, procedures, guidelines or directives specific to Charity Care fraud matters. Even if such documents specific to Charity Care fraud matters existed, they would be exempt from disclosure as advisory, consultative or deliberative material. See N.J.S.A. 47:1A-1.1.

For the above reasons, your request is denied.

In addition to the reasons for denial set forth above, OSC reserves the right to supplement the reasons with any additional basis for exception to public access as may hereinafter also be determined to apply

Very truly yours,

Robert Shane
Records Custodian