Kathleen Sibelius announced “nationwide takedown” by Medicare Fraud Strike Force operations‚ in eight cities that resulted in charges against 89 individuals‚ which included doctors‚ nurses and other licensed medical professionals‚ for their alleged participation in Medicare fraud schemes involving approximately $223 million in false billings. In Chicago‚ seven individuals were charged‚ including two doctors‚ with a variety of health care fraud schemes. This (sixth) nationwide takedown targeted eight cities:
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1. Identify the fraud risk factors at Peregrine‚ especially control environment factors and the tone at the top‚ using the fraud triangle. The fraud risk factors could be identified as incentives/pressures‚ opportunities‚ and attitudes/rationalization in fraud triangle. According to the case‚ Peregrine’ control environment had an essential issue on separation of duties. In PFG‚ only Russell Wasendorf could open the real bank balance‚ which gave the opportunity to Wasendorf. Peregrine was suffer from
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MODULE 3: CIT CASE QUESTIONS 1. The three aspects of fraud - Perceived pressure‚ Rationalization‚ and Opportunity were present in the CIT case as follows: Pressure- Niakan was placed under much pressure to meet monthly targets. The senior VP Ms. Thompson had earlier criticized his performance when it fell below expectations. Niakan had also been warned in his 2002 annual review that his team needed to improve end of lease sales and inventory returns. Apart from this work angle Niakan had personal
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Case Study1: And the Fraud Continues A business can not work out without an account system‚ which includes internal. Internal controls are used by companies to make sure financial information is accurate and valid. Strong internal controls are signs of a financially healthy company and protect the company’s integrity. Strong internal controls can also increase a company’s profitability. There are several types of internal controls
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Coding Fraud Michael Anastasio Ultimate Medical Academy Before answering the questions “what are my responsibilities for billing on a procedure that was not performed but asked to do so anyway”‚ Let me explain a little on Medical Billing Fraud? It is an attempt to fraudulently obtain payments from insurance carriers. Fraud in medical billing cost tax payers and medical providers millions of dollars annually (all-things-medical-billing.com). In 1996‚ HIPPA established the Health Care Fraud and
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Question 1: Name two cases in which companies have committed frauds by misstating inventory. Crazy Eddie and Goodner Brothers case are the good example for the inventory fraud cases. Question 2: What makes the intentional misstatement of inventory difficult to detect? When you have the most senior management of the company‚ particularly its financial management‚ consciously setting out to fool the auditors‚ to hide information from them‚ as they testified in the Monus trial‚ it’s very hard to
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MEMO TO: Darlene Wardlaw FROM: Bradley Crumpler DATE: September 20‚ 2014 RE: Staffing Memo for the Apollo Shoes‚ Inc. audit for 12/31/2014 After reviewing last year’s (2013) 10-K filing with the SEC‚ the board of directors’ minutes‚ and other documents pertaining to Apollo Shoes‚ Inc. here is our initial recommendation for staffing requirements: Audit engagement partner * Audit manager * It audit specialist Tax partner Quality assurance partner Legal specialist Audit Staff * Audit Engagement
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affordable and the expensive item the same? Let’s analyze expensive shoes for instance‚ find out its target market‚ response of the target market and the advertisements that you need to get those target market. What will be the return on investment for selling shoes online? We will find out the alternatives of selling expensive shoes online and come up with a recommendation that you can apply. Framework: Selling expensive shoes online. Is that I good idea or a bad idea. Well‚ first let us analyze
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Bernie Madoff Fraud Case Bernie Madoff Fraud Case Introduction One of the largest fraud cases of all times is that of the “Bernard Madoff Case.” According to Armstrong (2008)‚ “for a number of years Madoff managed to lure billions of dollars away from huge charities‚ as well as wealthy individuals in both the United States and Europe by getting them to invest in his hedge fund. This he did by offering extraordinary returns to investors‚ until his scheme eventually reached a staggering $50
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Insurance Fraud A gang of Russian crooks ran a record-setting‚ $279 million fraud that exploited New York’s “no-fault” auto –accident law‚ authorities said 2/29/12. The gang worked with corrupt doctors to set up more than 100 phony medical clinics across the city. There‚ they generated fake bills for the treatment of “injuries” that “ranged from wild exaggerations to outright fabrications‚” Manhattan US Attorney Preet Bharara said. The fraudsters took advantage of the “patient-friendly provisions”
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