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STATE OF OKLAHOMA
1st Session of the 58th Legislature (2021)
HOUSE BILL 2236 By: May
AS INTRODUCED
An Act relating to workers ' compensation; amending
Section 6, Chapter 208, O.S.L. 2013, as last amended
by Section 4, Chapter 476, O.S.L. 20 19 (85A O.S.
Supp. 2020, Section 6), which relates to fraud;
providing that failure to report material change in
income is a felony; prescribing punishment; and
providing an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOM A:
SECTION 1. AMENDATORY Section 6, Chapter 208, O.S.L.
2013, as last amended by Section 4, Chapter 476, O.S.L. 2019 (85A
O.S. Supp. 2020, Section 6), is amended to read as follows:
Section 6.
A. 1. a. Any person or entity who mak es any material false
statement or representation, who willfully and
knowingly omits or conceals any material information,
or who employs any device, scheme, or artifice, or who
aids and abets any person for the purpose of:
(1) obtaining any benefit or pay ment,
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(2) increasing any claim for benefit or payment, or
(3) obtaining workers' compensation coverage under
this act the Administrative Workers ' Compensation
Act,
shall be guilty of a felony punishable pursuant to
Section 1663 of Title 21 of the Oklahoma Statutes.
b. A material false statement or representation includes,
but is not limited to, attempting to obtain treatment
or compensation for body parts that were not injured
in the course and scope of employment.
c. Fifty percent (50%) of any criminal fin e imposed and
collected under this section shall be paid and
allocated in accordance with applicable law to the
Workers' Compensation Commission Revolving Fund.
2. Any person or entity with whom any person identified in
division (1) of subparagraph a of p aragraph 1 of this subsection has
conspired to achieve the proscribed ends shall, by reason of such
conspiracy, be guilty as a principal of a felony.
B. Except for forms submitted through the Electronic Data
Interchange system employed by the Workers' Compensation Commission
pursuant to Section 101 of this title, a copy of division (1) of
subparagraph a of paragraph 1 of subsection A of this section shall
be included on all forms prescribed by the Commission for the use of
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injured employees claiming benefi ts and for the use of employers in
responding to employees ' claims under this act.
C. While receiving temporary total disability benefits, failing
to report a material change in income to an employer, insurance
carrier, or third-party administrator shall be a felony punishable
pursuant to Section 1663 of Title 21 of the Oklahoma Statutes.
D. If the Workers' Compensation Commission or the Attorney
General finds that a violation of division (1) of subparagraph a of
paragraph 1 of subsection A of this sectio n has been committed, or
that any other criminal violations in furtherance of this act were
committed, the chair of the Commission or the Attorney General shall
refer the matter for appropriate action to the prosecuting attorney
having criminal jurisdictio n over the matter.
D.
E. 1. a. There shall be established within the Office of the
Attorney General a Workers ' Compensation Fraud
Investigation Unit, funded by the Commission. The
Attorney General shall appoint a Director of the
Workers' Compensation Fraud Investigation Unit, who
may also serve as the director of any other designated
insurance fraud investigation division within the
Attorney General's office.
b. (1) The Unit shall investigate workers ' compensation
fraud, any additional criminal violations that
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may be related to workers ' compensation fraud,
and any other insurance fraud matters as may be
assigned at the discretion of the Attorney
General.
(2) The Attorney General shall designate the
personnel assigned to the Unit, who, on meeting
the qualifications established by the Oklahoma
Council on Law Enforcement Education and
Training, shall have the powers of specialized
law enforcement officers of the State of Oklahoma
for the purpose of conducting investigations
under this subparagraph. Personnel hired as
specialized law enforcement officers shall have a
minimum of three (3) years of certified law
enforcement experience or its equivalent in
national or military law enforcement experience
as approved by the Oklahoma Council on Law
Enforcement Education and Training.
2. The Attorney General and his or her deputies and assistants
and the Director of the Workers ' Compensation Fraud Investigation
Unit and his or her deputies and assistants shall be vested with the
power of enforcing the requirements of this section.
3. It shall be the duty of the Unit to assist the Attorney
General in the performance of his or her duties. The Unit shall
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determine the identity of employees in this state who have violated
division (1) of subparagraph a of paragraph 1 of subsection A of
this section and report the violation to the Office of the Attorney
General and the Commission. The Attorney General shall report the
violation to the prosecuting attorney having jurisdiction over the
matter.
4. a. In the course of any inv estigation being conducted by
the Unit, the Attorney General and his or her deputies
and assistants and the Director and his or her
deputies and assistants shall have the power of
subpoena and may:
(1) subpoena witnesses,
(2) administer oaths or affirmatio ns and examine any
individual under oath, and
(3) require and compel the production of records,
books, papers, contracts, and other documents.
b. The issuance of subpoenas for witnesses shall be
served in the same manner as if issued by a district
court.
c. (1) Upon application by the commissioner or the
Director of the Unit, the district court located
in the county where a subpoena was served may
issue an order compelling an individual to comply
with the subpoena to testify.
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(2) Any failure to obey the ord er of the court may be
punished as contempt.
d. If any person has refused in connection with an
investigation by the Director to be examined under
oath concerning his or her affairs, then the Director
is authorized to conduct and enforce by all
appropriate and available means any examination under
oath in any state or territory of the United States in
which any officer, director, or manager may then
presently be to the full extent permitted by the laws
of the state or territory.
e. In addition to the punish ments described in paragraph
1 of subsection A of this section, any person
providing false testimony under oath or affirmation in
this state as to any matter material to any
investigation or hearing conducted under this
subparagraph, or any workers ' compensation hearing,
shall upon conviction be guilty of perjury.
5. Fees and mileage of the officers serving the subpoenas and
of the witnesses in answer to subpoenas shall be as provided by law.
6. a. Every carrier or employer who has reason to suspect
that a violation of division (1) of subparagraph a of
paragraph 1 of subsection A of this section has
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occurred shall be required to report all pertinent
matters to the Unit.
b. No carrier or employer who makes a report for a
suspected violation of division (1) o f subparagraph a
of paragraph 1 of subsection A of this section by an
employee shall be liable to the employee unless the
carrier or employer knowingly and intentionally
included false information in the report.
c. (1) Any carrier or employer who willfully and
knowingly fails to report a violation under
division (1) of subparagraph a of paragraph 1 of
subsection A of this section shall be guilty of a
misdemeanor and on conviction shall be punished
by a fine not to exceed One Thousand Dollars
($1,000.00).
(2) Fifty percent (50%) of any criminal fine imposed
and collected under this subparagraph shall be
paid and allocated in accordance with applicable
law to the fund administered by the Commission.
d. Any employee may report suspected violations of
division (1) of subparagraph a of paragraph 1 of
subsection A of this section. No employee who makes a
report shall be liable to the employee whose suspected
violations have been reported.
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E. F. 1. For the purpose of imposing criminal sanctions or a
fine for violation of the duties of this act, the prosecuting
attorney shall have the right and discretion to proceed against any
person or organization responsible for such violations, both
corporate and individual liability being intended by this act.
2. The prosecuting attorney of the district to whom a suspected
violation of subsection A of this section, or any other criminal
violations that may be related thereto, have been referred shall,
for the purpose of assisting him or her in such prosecutions, have
the authority to appoint as special deputy prosecuting attorneys
licensed attorneys-at-law in the employment of the Unit or any other
designated insurance fraud investigation division within the
Attorney General's office. Such special deputy prosecuting
attorneys shall, for the purpose of the prosecutions to which they
are assigned, be responsible to and report to the prosecuting
attorney.
F. G. Notwithstanding any other provision of law, investigatory
files as maintained by the Attorney General 's office and by the Unit
shall be deemed confidential and privileged. The files may be made
open to the public once the investigation is closed by the Director
of the Workers' Compensation Fraud Investigation Unit with the
consent of the Attorney General.
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G. H. The Attorney General, with the cooperation and assistance
of the Commission, is authorized to establish rules as may be
necessary to carry out the provisions of this section.
H. I. Nothing in this section shall be deemed to create a civil
cause of action.
I. J. Except for forms submitted through the Electronic Data
Interchange system employed by the Commission pursuant to Section
101 of this title, the Commission shall include a statement on all
forms for notices and instructions to employees, employers, carriers
and third-party administrators that any person who commits workers '
compensation fraud, upon conviction, shall be guilty of a felony
punishable by imprisonment, a fine or both.
J. K. If an injured employee is charged with workers '
compensation fraud, any pending workers' compensation proceeding,
including benefits, shall be stayed after the preliminary hearing is
concluded and the claimant is bound over and shall remain stayed
until the final disposition of the criminal case. All notice
requirements shall continue during the stay.
K. L. If the Attorney General 's Office is in compliance with
the discovery provisions of Section 258 of Title 22 of the Oklahoma
Statutes, medical records created for the purpose of treatment and
medical opinions obtained during the investigation shall be
admissible at the preliminary hearing without the appearance of the
medical professional creating such records or opinions. However,
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when material evidence dispositive to the issues of whether there
was probable cause the crime was committed and whether the defendant
committed the crime, was not included in a report or opinion
admitted at preliminary hearing, but might be presented at a
pretrial hearing by a medical professional who created such report
or opinion, the judge may, upon the motion of either party, order
the appearance of the medical professional creating such report or
opinion. Questions of fact regarding the conduct of the defendant
that conflict with the findings of the medical professional
evaluating the defenda nt shall not constitute material evidence. In
the event of such motion, notice shall be given to the Attorney
General's Workers' Compensation Fraud and Investigation and
Prosecution Unit. A hearing shall be held and, if the motion is
granted, the evidenc e shall not be presented fewer than five (5)
days later.
L. M. Any person or entity who, in good faith and exercising
due care, reports suspected workers ' compensation fraud or insurance
fraud, or who allows access to medical records or other information
pertaining to suspected workers ' compensation or insurance fraud, by
persons authorized to investigate a report concerning the workers '
compensation and insurance fraud, shall have immunity from any civil
or criminal liability for such report or access. A ny such person or
entity shall have the same immunity with respect to participation in
any judicial proceeding resulting from such reports. For purposes
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of any civil or criminal proceeding, there shall be a presumption of
good faith of any person making a report, providing medical records
or providing information pertaining to a workers ' compensation or
insurance fraud investigation by the Attorney General, and
participating in a judicial proceeding resulting from a subpoena or
a report.
SECTION 2. This act shall become effective November 1, 202 1.
58-1-6868 MAH 01/11/21