Healthcare Fraud and Abuse As we head into the next four years under the Obama administration‚ many Americans are hearing more and more about healthcare reform and what needs to be done to fix the ailing healthcare system. Part of the dramatic increase in healthcare costs is due to Medicare fraud abuse. Healthcare fraud is defined as making false statements or representations of material facts in order to obtain benefits or payment. Healthcare abuse is defined as practices involving the overuse
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sold huge amounts of its products to other companies at a discount‚ but kept the items in warehouses. On paper‚ the company appeared to have had high sales; however‚ Sunbeam’s warehouses were full of unsold product. This practice was uncovered by a financial analyst at investment firm Paine Webber‚ who downgraded the value of Sunbeam’s stock. Bill and hold isn’t illegal‚ but Sunbeam’s shareholders felt deceived and filed lawsuits. Sunbeam’s accounting firm‚ Arthur Andersen (later ruined by its involvement
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Case 1.9 ZZZZ Best Company‚ Inc. Delta. Describe the elements of the Fraud Triangle that apply to this case. Assume you are the perpetrator. Is there a better way to perpetrate this fraud? If there is‚ describe your method. Specify practical recommendations for the client to prevent this fraud from occurring in the future. The first element of the Fraud Triangle in the case of ZZZZ Best‚ case 1.9 is Incentives/Pressure. Incentives/Pressure- As a result of the pressure placed on a person who
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Freddie Mac Fraud Thanaphan Darnsomboon PME604 Project Financial Management National University December 18‚ 2012 Freddie Mac Fraud The definition of fraud is “an intentional deception or deceit‚ perpetrated for profit or to gain some unfair or dishonest advantage” (dictionary.com). Fraud is a breach of law and can be punishable by law. Mortgage fraud is one of the financial crimes where a company materially misrepresents or omits information on its mortgage loan documentation in order to
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Abstract A fraud is an act of deceiving others for personal gain but is not usually followed by a crime. The symptoms of fraud or the red flags help understand the slight difference between a corporate fraud and a corporate crime. The continual financial frauds leading to corporate collapse and the failure of the statutory audit to detect and prevent fraudulent activities of the perpetrators lead investors and the firms and individuals to suffer. This contributed to the increased need for investigating
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enough to pay the bills. By the early 1990’s‚ Phar-Mor declared bankruptcy due to fraudulent financial reporting and misappropriation of assets‚ making it one of the largest frauds in U.S. history. Below‚ we will use auditing standard AU 316.85 Appendix A in conjunction with the video “How to Steal $500 million” to analyze how incentives/pressures‚ opportunities‚ and attitudes/rationalizations allowed for fraud to start and continue at Phar-Mor. Incentives/Pressures Annual reoccurring losses
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Reynoso‚ Rheyniel Manaog January 6‚ 2014 Forensic Accounting/AIA1010/EB-301/7:30-9:00 Professor Dorega 2010244321 Part 1 Mr. Manuel V. Pangilinan has been a director of PLDT since November 24‚ 1998. He was appointed as Chairman of the Board of PLDT after serving as its President and CEO from November 1998 to February 2004. He is the Chairman of the Governance and Nomination‚ Executive Compensation and Technology Strategy Committees of the Board of Directors of PLDT. He
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| | |Financial Statement Fraud | |Navistar International Corporation | |
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When does employee fraud occur? It is commonly accepted that the presence of the three elements of the “Fraud Triangle” increases the risk of employee fraud: Motivation: The employee is somehow motivated to commit a fraud. Economic factors such as personal financial distress‚ substance abuse‚ gambling‚ overspending‚ or other similar addictive behaviors may provide motivation. The current national economic recession may serve to increase the incidence of such financial motivations. Opportunity:
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Healthcare Fraud - is knowingly and willfully executes or attempts to execute a scheme to defraud any healthcare benefit program‚ or to obtain by false or fraudulent pretense. Therefore‚ in order to prove fraud the government must prove that the act performed was knowingly‚ willfully and intentionally. Healthcare Abuse - is most frequently defined in terms of acts that are inconsistent with sound medical or business practice‚ is an unintentional practice is directly or indirectly results in an over
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