Computer fraud is the use of information technology to commit fraud. In the United States‚ computer fraud is specifically proscribed by the Computer Fraud and Abuse Act‚ which provides for jail time and fines. 1. Unauthorized access at North Bay Abdulswamad Nino Macapayad‚ a former accounts payable clerk for North Bay Health Care Group‚ admitted to using her computer to access North Bay’s accounting software without authorization‚ and in turn issued various checks payable to herself and others.
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Medicaid Fraud HCS/545 July 9‚ 2012 Medicaid fraud comes in many forms. A provider who bills Medicaid for services that he or she does not provide is committing fraud. Overstating the level of care provided to patients and altering patient records to conceal the deception is fraud. Recipients also commit fraud by failing to report or misrepresenting income‚ household members‚ residence‚ or private health insurance. Facilities have also been known to commit Medicaid fraud through false billing
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more basic concepts in fraud deterrence and detection is the fraud triangle. The fraud triangle is also known as Cressey’s Triangle‚ or Cressey’s Fraud Triangle. Cressey’s Fraud Triangle gets its name from Donald Cressey. Cressey was one of the “nations leading experts on the sociology of crime”. He authored a few books including Other People’s Money‚ Theft of the Nation‚ and co-authored Principles of Criminology with Edwin H. Sutherland. Cressey is honored by many anti-fraud organizations‚ including
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Medical Billing Fraud What is Medical Billing Fraud? It is an attempt to fraudulently obtain payments from insurance carriers. Medicare and Medicaid are the most susceptible to fraud because of their payment arrangements. Fraud in medical billing cost tax payers and medical providers millions of dollars annually. In 1996‚ HIPPA established the Health Care Fraud and Abuse Control Program (HCFAC) to help combat medical billing and health care fraud. Fraud is an act done with the knowledge that you
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Saudi Arabia THC China THC Polska Cause of the AAER In early 2006‚ a Commission filing over disclosures‚ accounting fraud and a FCPA injunctive action against Tyco was settled and led to the agreement of an overview of Tyco’s global organization. The investigation of the matter then led to the findings of the misconducts that Tyco is getting Charged for in this case. During the fiscal years 2006-2009‚ Tyco Inc. was found to be involved in several illicit payment schemes. The company filed
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Health Care Fraud 1. Types of Health Care Fraud A. Health insurance B. Drug Fraud C. Punishment 2. Entities involved in Health care fraud A. Social a. Individuals B. Political a. Oversight b. Supreme Court input C. Cultural 3. Technology and health Care Fraud A. Billing Procedures B. Unbundling 4. Ethics involved with Fraud/Economic Impact a. Effects on Health Care b. Monitor outgoing monies
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patient to be able to safely discharge home‚ and back to their daily lives. The company is publicly traded‚ and has seen its share of controversy in the early 2000s. Richard Scrushy‚ founder and former CEO‚ was ultimately acquitted of accounting fraud‚ but was found guilty in civil court. The scandal was colossal‚ and rocked the industry and brought down top executives. The rapid growth of the company and the fraudulent activity impacted thousands of stakeholders. Scrushy was not thinking about
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approach of detecting fraud is anonymous tips and complaints. An organization like business entity should guide employees to provide useful information and to provide various ways and methods for individuals to contribute such kind of information. On the other hand‚ when the organization received the information provided‚ it should have an effective and efficient way to collect and process these complaints‚ dissatisfaction and information. 2. One of the important thing in fraud investigation is timing
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HISTORY AND PHYSICAL EXAMINATION Patient Name: Adela Torres Patient ID: 132463 RM #: 541 Date of Admission: 06/22/---- Admitting Physician: Leon Medina MD‚ Internal Medicine Admitting Diagnosis: Stomatitis‚ possibly methotrexate related CHIEF COMPLAINT: Swelling of lip causing difficulty swallowing HISTORY OF PRESENT ILLNESS: This patient is a 57 yr. old‚ Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient
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Anti Fraud Programs and Controls (Deloitte) What is Fraud? The Public Company Accounting Oversight Board (PCAOB) defines fraud as “an intentional act that results in a material misstatement in financial statements that are the subject of an audit. Two types of misstatements relevant to the auditor’s consideration of fraud include: misstatements arising from fraudulent financial reporting and misstatements arising from misappropriation of assets.” There are additional types of fraud that should also
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