42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

The Liability of Colleges and Universities for Fraud, Waste, and Abuse in Federally Funded Grants and Projects.

ERIC Educational Resources Information Center

Gordon, Steven D.

1996-01-01

The federal government's war on fraud, waste, and abuse in expenditure of federal funds has reached college campuses. Institutions that fail to heed this development are vulnerable to harsh sanctions. They must tighten accounting practices and recognize their liability for fraudulent practices of faculty and students. Internal investigations and…

78 FR 32257 - Privacy Act of 1974; Report of a New Routine Use for Selected CMS Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... systems of records to assist in preventing and detecting fraud, waste and abuse. The new routine use will... for the purpose of preventing and detecting fraud, waste and abuse, pursuant to section 1128C(a)(2) of the Social Security Act (``the Act''). At section 1128C(c) of the Act, a health plan is defined as a...

Report: EPA Office of Inspector General’s Report on Reducing Fraud, Waste, and Abuse in the Small Business Innovative Research Program, as Required by the National Defense Authorization Act for Fiscal Year 2012, Pub. L. 112-81 (2012)

EPA Pesticide Factsheets

September 28, 2012. The EPA OIG is required by Section 5143 of the NDA Act for Fiscal Year 201 2, Pub. L. No. 112-81 (2012), to report on reducing vulnerability to fraud, waste and abuse in the Small Business Innovative Research (SBIR) program.

DOD Financial Management: Ongoing Challenges in Implementing the Financial Improvement and Audit Readiness Plan

DTIC Science & Technology

2011-09-15

programs and operations at high risk of being vulnerable to fraud, waste, and abuse.1 Despite several reform initiatives, DOD’s financial management...remains on GAO’s high- risk list today. Long- standing and pervasive weaknesses in DOD’s financial management and related business processes and systems...GAO has identified as being at high risk of waste, fraud, abuse, and mismanagement. The seven specific DOD high- risk areas are (1) approach to

Department of Justice

MedlinePlus

... of Seized Property Submit a Complaint Report Waste, Fraud, Abuse or Misconduct Find a Form Register, Apply ... Preparer Sentenced to Prison For Tax and Bankruptcy Fraud Thursday, November 16, 2017 Assistant Attorney General Makan ...

78 FR 73923 - Privacy Act of 1974, as Amended; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... data sources, as well as access to analytical services designed to detect fraud and systemic improper... systemic fraud, waste, and abuse within Federal programs; (d) Disclosure to (1) a Federal agency, its... prosecuting violations of, or for enforcing or implementing, a statute, rule, regulation, order, or license...

Defense Infrastructure: DOD Efforts Regarding Net Zero Goals

DTIC Science & Technology

2016-01-12

and reducing, reusing, and recovering waste streams to add zero waste to landfills . House Report 114-102, accompanying a bill for the National...Testimony Order by Phone Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

EPA OIG Hotline

EPA Pesticide Factsheets

The EPA OIG Hotline receives complaints of fraud, waste, and abuse in EPA programs and operations including mismanagement or violations of law, rules, or regulations by EPA employees or program participants.

Suspension and Debarment Program

EPA Pesticide Factsheets

EPA's management authority includes an effective administrative tool to address waste, fraud, abuse, poor performance, environmental noncompliance or other misconduct...the authority to suspend and or debar individuals and entities.

Compassionate Allowances

MedlinePlus

... Report Fraud, Waste or Abuse Site Map Other Government Websites: Benefits.gov Disability.gov MyMoney.gov Regulations.gov USA.gov Other Government Sites Follow: Twitter Facebook YouTube Blog More Social ...

Benefits for People with Disabilities

MedlinePlus

... Report Fraud, Waste or Abuse Site Map Other Government Websites: Benefits.gov Disability.gov MyMoney.gov Regulations.gov USA.gov Other Government Sites Follow: Twitter Facebook YouTube Blog More Social ...

48 CFR 509.406-3 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., Reporting Waste, Fraud, Abuse, and Corruption. If, after investigation, the OIG believes a cause for... last known home and business addresses, zip codes, and DUNS Numbers. (3) A statement of facts. (4...

Whistleblowing in the pharmaceutical industry in the United States, England, Canada, and Australia.

PubMed

Boumil, Sylvester James; Nariani, Ashiyana; Boumil, Marcia M; Berman, Harris A

2010-04-01

Fraud and abuse in the spending of public monies plague governments around the world. In the United States the False Claims Act encourages whistleblowing by private individuals to expose evidence of fraud. They are rewarded for their efforts with monetary compensation and protection from retaliation. Such is not the case in Canada, England, and Australia. Although some recent legislation has increased the protections afforded to whistleblowers, they are still likely to be viewed more as disloyal employees than courageous public servants, and there is little incentive to risk their jobs and reputation. Qui tam laws provide a police force of thousands in the effort to reduce rampant fraud, waste, and abuse, and would be an asset in any health-care system where pubic health policy requires conservation of resources.

77 FR 25013 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... Inspector General for Tax Administration (TIGTA) OMB Number: 1505-0217. Type of Review: Extension without... administration of internal revenue laws, including the prevention and detection of fraud, waste, and abuse...

Poster: Whistleblower Protection Ombudsman for the EPA OIG

EPA Pesticide Factsheets

The Whistleblower Protection Enhancement Act of 2012 Exit was signed into law on November 27, 2012. The Act strengthens protection for federal employees who blow the whistle on waste, fraud, and abuse in government operations.

75 FR 60422 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... November 1, 2010. Title and OMB Number: Trustee Report, DD Form 2826, OMB Number 0730-0012. Type of Request... fraud, waste and abuse of Government funds and member's benefits. Affected Public: Individuals or...

Report on inspection of compliance with DOE Order 2030.4B at the Savannah River Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-03-01

The purpose of this inspection was to evaluate contractor compliance at the Savannah River Site (SRS) with Department of Energy (DOE) Order 2030.4B, {open_quotes}Reporting Fraud, Waste, And Abuse To The Office Of Inspector General.{close_quotes} The specific objective was to determine if the SRS management and operating (M&O) contractors were complying with the requirements in Paragraph 6.c. of DOE Order 2030.4B. These requirements are: (1) annual notification to employees of their duty to report allegations of fraud, waste, abuse, corruption, or mismanagement; (2) display and publish the DOE Office of Inspector General (OIG) Hotline telephone number in common areas of buildings;more » (3) display and publish the DOE OIG Hotline number in telephone books and newsletters; and (4) notify the OIG cases referred to other law enforcement entities.« less

Abuses in Federal Student Aid Programs: Hearings Before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs. United States Senate, One Hundred First Congress, Second Session (February 20, 26, 1990).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

This document presents oral testimony and prepared statements on the subject of federal student loan programs identified as particularly vulnerable to fraud, waste, and abuse. Opening statements by the four Senators (Nunn, Kohl, Roth, and Levin) stress the seriousness of increasing student loan defaults and abuses by proprietary, for profit, trade…

77 FR 18825 - Notice of Intent To Provide Expansion and Capacity Building Funding to the Incumbent Senior...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

...), and the Department of Justice to expand strategies to eliminate waste, fraud, and abuse in these... resources to use in outreach and educational efforts; Expertise and experience in reaching targeted...

Annual Plan for the EPA and CSB - FY 2014

EPA Pesticide Factsheets

How the OIG will promote economy, efficiency and effectiveness, and prevent and detect fraud, waste and abuse, through independent oversight of the programs and operations of the EPA and the U.S. Chemical Safety and Hazard Investigation Board.

48 CFR 970.0370-1 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... management and quality control to discourage waste, fraud and abuse; and to ensure that components, products, and services that are provided to the Department of Energy (DOE) satisfy the contractor's obligations... for effective management systems and internal controls within their areas of assigned responsibility...

Control of fraud and abuse in Medicare and Medicaid.

PubMed

Pies, H E

1977-01-01

This Comment explores issues concerning the control of fraud and abuse in health programs financed with public funds, specifically the Medicare and Medicaid programs. It summarizes the nature, scope, and possible causes of what some regard as a fraud and abuse "crisis," and points out the difficulties and obstacles facing those who attempt to develop legislative and executive action aimed at controlling fraud and abuse. Recent federal initiatives in fraud and abuse control are examined, and a brief summary of key provisions of H.R. 3 (the Medicare-Medicaid Anti-fraud and Abuse Amendments, which may prove to be a landmark piece of legislation in this area) is provided. The author emphasizes that more effective control of fraud and abuse is necessary if further expansion of government financing of health programs, including national health insurance, is to occur in the near future. At the same time, caution must be taken not to neglect the appropriate use of other mechanisms necessary for reducing the costs of medical care and improving its quality. In addition, it is likely that efforts to stem fraud and abuse will raise important medicolegal and public policy issues that will require careful interdisciplinary consideration.

42 CFR 457.232 - Refunding of Federal Share of CHIP overpayments to providers and referral of allegations of waste...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Refunding of Federal Share of CHIP overpayments to providers and referral of allegations of waste, fraud or abuse to the Office of Inspector General. 457.232 Section 457.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S...

39 CFR 230.1 - Establishment and authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... responsible for detecting and preventing fraud, waste, and abuse in the programs and operations of the Postal... Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION OFFICE OF INSPECTOR GENERAL... the Inspector General Act of 1978, as amended (5 U.S.C. App.3), and 39 U.S.C. 410, an independent...

[High Risk Federal Program Areas]: An Overview. High-Risk Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This report reviews the status of government agencies and operations that have been identified as at "high risk" for waste, fraud, abuse, and mismanagement; describes successful progress in some agencies; and looks at recent reform legislation. Six categories being targeted include accountability of defense programs, ensuring that all…

75 FR 38112 - Organization, Functions, and Delegations of Authority; Part G; Indian Health Service; Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Organization, Functions, and... Ethics Staff (PIES) (GAL1) (1) Directs the fact-finding and resolution of allegations of impropriety such as mismanagement of resources, fraud, waste, and abuse, violations of the Standards of Ethical...

Defense Contracts: DOD’s Requests for Information from Contractors to Assess Prices

DTIC Science & Technology

2015-08-01

manuals $4,000,000 Commercial Goodyear tires $3,290,902 Commercial Multiband manpack radio systems and operator training $1,742,712...by Phone Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

75 FR 2457 - Defense Federal Acquisition Regulation Supplement; Business Systems-Definition and Administration...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... INFORMATION: A. Background Contractor business systems and internal controls are the first line of defense against waste, fraud, and abuse. Weak control systems increase the risk of unallowable and unreasonable... Office of Management and Budget (OMB) as follows: (1) Accounting Systems--OMB Clearance 9000-0011; (2...

76 FR 28855 - Defense Federal Acquisition Regulation Supplement; Business Systems-Definition and Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... business systems and internal controls are the first line of defense against waste, fraud, and abuse. Weak control systems increase the risk of unallowable and unreasonable costs on Government contracts. To...'s accounting system rather than the adequacy of the contractor's control environment and overall...

77 FR 60630 - Structure and Practices of the Video Relay Service Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [CG Docket No. 10-51; FCC 11-54] Structure and Practices of the Video Relay Service Program AGENCY: Federal Communications Commission. ACTION: Correcting... address fraud, waste, and abuse in the Video Relay Service (VRS) industry. DATES: Effective October 4...

10 CFR 1010.103 - Reporting wrongdoing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Reporting wrongdoing. 1010.103 Section 1010.103 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) CONDUCT OF EMPLOYEES § 1010.103 Reporting wrongdoing. (a) Employees shall, in fulfilling the obligation of 5 CFR 2635.101(b)(11), report fraud, waste, abuse, and corruption...

77 FR 5860 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

..., 2011); Education Jobs Fund, Public Law 111-226, 124 Stat. 2389, Sec. 101 (2010). Accordingly, the Board... fraud, waste, and abuse. Public Law 111-5, Sec. Sec. 1521, 1523(a)(1). The Education Jobs Fund required... contains information relevant to the retention of an employee or retention of a security clearance. That...

Guaranteed Student Loans: GAO High Risk Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

As part of a larger program to identify and analyze federal programs at high risk for waste, fraud, abuse and mismanagement, this publication presents an evaluation of the Federal Family Education Loan Program (FFELP), formerly the Guaranteed Student Loan Program. The analysis argues that the program has not been successful in protecting the…

An Overview. High Risk Series.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

42 CFR 424.570 - Moratoria on newly enrolling Medicare providers and suppliers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for fraud, waste or abuse in the Medicare program: (A) A particular provider or supplier type. (B) Any... enrollment of new Medicare providers and suppliers of a particular type or the establishment of new practice locations of a particular type in a particular geographic area. (ii) CMS will announce the temporary...

75 FR 18043 - Combating Noncompliance With Recovery Act Reporting Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... tracking recovery dollars and to elimination of waste, fraud, and abuse by recipients of hard-earned...) identify every prime recipient under an obligation to file a report on FederalReporting.gov arising from... that every such recipient has filed a report. Any prime recipient that has failed to report is not...

77 FR 23247 - Notice of Debarment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... the schools and libraries universal service support mechanism (or ``E-Rate Program'') for a period of three years. The Bureau takes this action to protect the E-Rate Program from waste, fraud and abuse.... March 15, 2012 DA 12-409 VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED AND E-MAIL Dr. Dennis L. Bruno, c/o...

76 FR 30841 - Structure and Practices of the Video Relay Service Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-27

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [CG Docket No. 10-51; FCC 11-54] Structure and Practices of the Video Relay Service Program; Correction AGENCY: Federal Communications Commission. ACTION... address fraud, waste, and abuse in the Video Relay Service (VRS) industry. DATES: Effective June 1, 2011...

77 FR 18106 - Structure and Practices of the Video Relay Service Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [CG Docket No. 10-51; FCC 11-54] Structure and Practices of the Video Relay Service Program AGENCY: Federal Communications Commission. ACTION: Final rule... adopted by the FCC to prevent fraud, waste, and abuse in the Video Relay Service (VRS) industry. DATES...

42 CFR 457.915 - Fraud detection and investigation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and abuse cases. (2) Methods for investigating fraud and abuse cases that— (i) Do not infringe on legal rights of persons involved; and (ii) Afford due process of law. (b) State program integrity unit... implement procedures for referring suspected fraud and abuse cases to the State program integrity unit (if...

An Evaluation of the Effectiveness of Policy Communication in the Professional Development Centre's Training Programs.

ERIC Educational Resources Information Center

Rudasill, Susann E.

In the face of rising juvenile violent crime rates and media talk of waste, abuse, fraud, and ineffectiveness within the Florida Department of Health and Rehabilitative Services (HRS), the state recommended the adoption of a family-focused approach in client intervention strategy. The Florida Atlantic University Professional Development Centre…

Defense Transportation: DOD Needs to Improve the Evaluation of Safety and Performance Information for Carriers Transporting Security-Sensitive Materials

DTIC Science & Technology

2015-12-01

caught on fire in September 2014 near Crawfordville, Georgia. The tires and the trailer were burned off. See figure 11. There were no reported...Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

Analysis of the United States Defense and Civilian Contracting Workforce’s Training on Procurement Fraud, Waste and Abuse

DTIC Science & Technology

2013-09-01

Federal Acquisition Institute. (2013a). FAC-C certification requirements. Retrieved from http://www.fai.gov/ drupal /certification/fac-c-certification...www.fai.gov/ drupal /sites/default/files/pdfs/FY%202011%20Annual%20Re port%20on%20the%20Federal%20Acquisition%20Workforce.pdf. Federal Acquisition

Fraud, Waste, and Abuse and Contingency Contracts: A Critical Assessment of DoD and Army Processes

DTIC Science & Technology

2011-12-16

corporations included Kellogg, Brown and Root (KBR), Blackwater , Halliburton and others that quickly augmented military forces in the more lengthy conflicts...through the Assistant Secretary of Defense. It is made up of 32 members and chairmen from the Army, Air Force, Navy , as well as chairmen from the

77 FR 15026 - Privacy Act of 1974; Farm Records File (Automated) System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

... Mining Project, all program data collected and handled by either RMA or FSA will be treated with the full... data warehouse and data mining operation. RMA will use the information to search or ``mine'' existing... fraud, waste, and abuse. The data mining operation is authorized by the Agricultural Risk Protection Act...

76 FR 1472 - Agenda and Notice Meeting of the Recovery Independent Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

.... SUMMARY: In accordance with the American Recovery and Reinvestment Act of 2009, Public Law 111-5 (Recovery... notify the general public of their opportunity to attend the meeting. DATES: The RIAP meeting will be... dialogue, with input from the public, on issues relating to fraud, waste, and abuse of Recovery Act funds...

77 FR 13319 - Information Collection Being Submitted to the Office of Management and Budget (OMB) for Emergency...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

...), via fax at 202-395-5167 or via Internet at [email protected] and to Judith B. Herman, Federal Communications Commission, via the Internet at [email protected] . To submit your PRA... waste, fraud and abuse of the Universal Service Fund (USF or Fund). Among other things, the Lifeline...

Expanding physician education in health care fraud and program integrity.

PubMed

Agrawal, Shantanu; Tarzy, Bruce; Hunt, Lauren; Taitsman, Julie; Budetti, Peter

2013-08-01

Program integrity (PI) spans the entire spectrum of improper payments from fraud to abuse, errors, and waste in the health care system. Few physicians will perpetrate fraud or abuse during their careers, but nearly all will contribute to the remaining spectrum of improper payments, making preventive education in this area vital. Despite the enormous impact that PI issues have on government-sponsored and private insurance programs, physicians receive little formal education in this area. Physicians' lack of awareness of PI issues not only makes them more likely to submit inappropriate claims, generate orders that other providers and suppliers will use to submit inappropriate claims, and document improperly in the medical record but also more likely to become victims of fraud schemes themselves.In this article, the authors provide an overview of the current state of PI issues in general, and fraud in particular, as well as a description of the state of formal education for practicing physicians, residents, and fellows. Building on the lessons from pilot programs conducted by the Centers for Medicare and Medicaid Services and partner organizations, the authors then propose a model PI education curriculum to be implemented nationwide for physicians at all levels. They recommend that various stakeholder organizations take part in the development and implementation process to ensure that all perspectives are included. Educating physicians is an essential step in establishing a broader culture of compliance and improved integrity in the health care system, extending beyond Medicare and Medicaid.

Yemen: DOD Should Improve Accuracy of Its Data on Congressional Clearance of Projects as It Reevaluates Counterterrorism Assistance

DTIC Science & Technology

2015-04-01

Section 1206 project was grounded in October 2014 because it lacked spare tires , resulting in a loss of medium-lift capability for the Yemeni Air Force...Testimony Order by Phone Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

Inspector General - Personal Staff - Joint Staff - The National Guard

Science.gov Websites

contacting the Office of The Inspector General The IG cannot action request with incomplete DA 1559s or AF Form 102s. In order to have an IG begin work on a matter, personnel must prepare a written IG Action General Action Request (DA 1559) Air Force - The Inspector General Personal and Fraud, Waste & Abuse

42 CFR 455.17 - Reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud Detection and Investigation Program § 455.17 Reporting requirements. The agency must report the following fraud or abuse... complaints of fraud and abuse made to the agency that warrant preliminary investigation. (b) For each case of...

20 CFR 632.125 - Responsibilities of Native American grantees, subgrantees and contractors for preventing fraud...

Code of Federal Regulations, 2012 CFR

2012-04-01

..., subgrantees and contractors for preventing fraud and program abuse and for general program management. 632.125... and for general program management. (a) Each Native American grantee shall establish and use internal program management procedures sufficient to prevent fraud and program abuse, including subgrantee and...

20 CFR 632.125 - Responsibilities of Native American grantees, subgrantees and contractors for preventing fraud...

Code of Federal Regulations, 2011 CFR

2011-04-01

..., subgrantees and contractors for preventing fraud and program abuse and for general program management. 632.125... and for general program management. (a) Each Native American grantee shall establish and use internal program management procedures sufficient to prevent fraud and program abuse, including subgrantee and...

Universal Service Fund: Background and Options for Reform

DTIC Science & Technology

2010-03-11

pursues violators and initiates enforcement actions including notices of liability, suspensions , consent decrees, and debarments .46 The Department...series of measures to safeguard the USF to deter fraud, waste, and abuse. Included in the measures taken are those that extend the debarment rules...three years) and sanctions for criminal and civil violations beyond the Schools and Libraries Program to cover all four programs; tighten rules

Financial Management: Education's Financial Management Problems Persist. Testimony before the Task Force on Education, Committee on the Budget, House of Representatives.

ERIC Educational Resources Information Center

Jarmon, Gloria L.; Engel, Gary T.

This document discusses the Department of Education's (DOE) fiscal year 1999 financial audit results; the relationship between the audit findings and the potential for waste, fraud, and abuse; and the results of the General Accounting Office's (GAO) review of the DOE's grantback account. The DOE's financial activity is important to the federal…

Telecommunications Technology: Federal Funding for Schools and Libraries. Report to the Chairman, Committee on Commerce, and the Chairman, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

This document reports on federally created or facilitated programs for helping schools and libraries with their telecommunications and information technology efforts. Brief answers to specific questions on program characteristics, potential for duplication, coordination efforts, and available information on fraud, waste, and abuse are provided in…

Warfighter Support: Army Has Taken Steps to Improve Reset Process, but More Complete Reporting of Equipment and Future Cost Is Needed

DTIC Science & Technology

2012-05-01

asphalt spreaders ), other semi-trucks and trailers, palletized loading systems, and heavy equipment transports. As table 3 shows, the actual reset...Copies of GAO Reports and Testimony Order by Phone Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

Recent developments in false claims enforcement: a minefield for health care providers.

PubMed

Whitaker, Glenn V; Walton, Victor A

2007-01-01

Actions under the False Claims Act represent potentially billions of dollars in damages returned to the state and federal governments each year for fraud recovery. Over the past several years, health care providers have been the target of about half of the FCA suits filed and have paid out an even greater percentage of the damages recovered. Because of the enumerable opportunities for fraud, waste, and abuse in the health care industry, it will likely continue to be a prominent target of FCA suits. Key provisions of the Deficit Reduction Act of 2005, effective on January 1, 2007, will only increase the reach of the FCA. Providers beware.

Securing insurance protection against fraud and abuse liability.

PubMed

Callison, S

1999-07-01

Healthcare organizations concerned about corporate compliance need to review securing appropriate insurance coverage as part of their corporate compliance program. Provider organizations often mistakenly expect that their directors and officers liability (D&O), malpractice, or standard errors and omissions (E&O) insurance policies will cover the cost of Medicare fraud and abuse fines. The insurance industry has developed a specific billing E&O insurance product to cover providers that run afoul of government fraud and abuse statutes.

Investigative Operations: Use of Covert Testing to Identify Security Vulnerabilities and Fraud, Waste, and Abuse

DTIC Science & Technology

2007-11-14

including evaluations of controls over radioactive materials and security at America’s borders, airport security , sales of sensitive and surplus...officers. The details of this March 2006 report are classified; however, TSA has authorized this limited discussion. Airport Security Testing Sale of...of covert security vulnerability testing of numerous airports across the country. During these covert tests, our investigators passed through airport

Preventing fraud and abuse in low income weatherization programs: The proceedings of the EORI (Economic Opportunity Research Institute) Roundtable

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1987-01-01

The Economic Opportunity Research Institute (EORI) sponsored a national Roundtable on ''Prevention of Fraud and Abuse in Low Income Weatherization Programs'' in Washington, DC on March 23-24, 1987. Funding for the Roundtable and these Proceedings was provided jointly by the US Departments of Health and Human Services/Office of Family Assistance and Energy through Grant FG01-85CE63438. The purpose of the Roundtable was two-fold: (1) to share successful and possible replicable state and local measures to prevent fraud and abuse in low income conservation programs; and (2) to identify any areas in these programs where the potential for fraud and abuse maymore » exist and examine methods to curb such potential. A Task Force representing eight states and including both state and local low income conservation program operators was chosen by EORI and the HHS Office of Family Assistance. The Agencies represented had developed successful preventive approaches to curbing fraud and abuse. Additional participants in the Roundtable included representatives from the US Department of Energy, Weatherization Assistance Program Office and the HHS Office of Energy Assistance, along with other state and local program operators.« less

Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study

PubMed Central

Joudaki, Hossein; Rashidian, Arash; Minaei-Bidgoli, Behrouz; Mahmoodi, Mahmood; Geraili, Bijan; Nasiri, Mahdi; Arab, Mohammad

2016-01-01

Background: We aimed to identify the indicators of healthcare fraud and abuse in general physicians’ drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse. Methods: We applied data mining approach to a major health insurance organization dataset of private sector general physicians’ prescription claims. It involved 5 steps: clarifying the nature of the problem and objectives, data preparation, indicator identification and selection, cluster analysis to identify suspect physicians, and discriminant analysis to assess the validity of the clustering approach. Results: Thirteen indicators were developed in total. Over half of the general physicians (54%) were ‘suspects’ of conducting abusive behavior. The results also identified 2% of physicians as suspects of fraud. Discriminant analysis suggested that the indicators demonstrated adequate performance in the detection of physicians who were suspect of perpetrating fraud (98%) and abuse (85%) in a new sample of data. Conclusion: Our data mining approach will help health insurance organizations in low-and middle-income countries (LMICs) in streamlining auditing approaches towards the suspect groups rather than routine auditing of all physicians. PMID:26927587

Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study.

PubMed

Joudaki, Hossein; Rashidian, Arash; Minaei-Bidgoli, Behrouz; Mahmoodi, Mahmood; Geraili, Bijan; Nasiri, Mahdi; Arab, Mohammad

2015-11-10

We aimed to identify the indicators of healthcare fraud and abuse in general physicians' drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse. We applied data mining approach to a major health insurance organization dataset of private sector general physicians' prescription claims. It involved 5 steps: clarifying the nature of the problem and objectives, data preparation, indicator identification and selection, cluster analysis to identify suspect physicians, and discriminant analysis to assess the validity of the clustering approach. Thirteen indicators were developed in total. Over half of the general physicians (54%) were 'suspects' of conducting abusive behavior. The results also identified 2% of physicians as suspects of fraud. Discriminant analysis suggested that the indicators demonstrated adequate performance in the detection of physicians who were suspect of perpetrating fraud (98%) and abuse (85%) in a new sample of data. Our data mining approach will help health insurance organizations in low-and middle-income countries (LMICs) in streamlining auditing approaches towards the suspect groups rather than routine auditing of all physicians. © 2016 by Kerman University of Medical Sciences.

Security Clearances: Additional Mechanisms May Aid Federal Tax-Debt Detection

DTIC Science & Technology

2015-03-18

it is requesting disclosure , and, as such, the agency may not obtain the complete tax -debt history of the individual nor would it be of use during...BagdoyanS@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this statement...Connect with GAO To Report Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

Financial Management: Education Faces Challenges in Achieving Financial Management Reform. Testimony before the Subcommittee on Oversight and Investigations, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

Jarmon, Gloria L.

This report provides a fiscal analysis of the Department of Education's 1999 financial audit results. It focuses on the relationship between the audit findings and the potential for waste, fraud, and abuse, and examines the status of an ongoing study of the Department's grantback account. It describes the ongoing accounting problems that have…

Student Financial Assistance Programs. Hearings Before a Subcommittee of the Committee on Government Operations, House of Representatives, Ninety-Fifth Congress, Second Session. July 27; August 3; and October 5, 1978.

ERIC Educational Resources Information Center

Congress of the U. S., Washington, DC. House Committee on Government Operations.

Three hearings held before the U.S. House of Representatives on student financial assistance programs were concerned with the manner in which the Office of Education's assistance programs were being administered, the extent and nature of fraud, waste and abuse, and the progress of the Department of Health, Education, and Welfare's (HEW) corrective…

Debarment and suspension. [of contractors

NASA Technical Reports Server (NTRS)

Whelan, Thomas J.

1987-01-01

The changing Government attitude toward contractor debarment and suspension is examined, with emphasis on the fact that the Government is more alert to fraud, waste, and abuse. Consideration is given to causes of debarment or suspension, procedures and due process hearings, settlement agreements, compliance programs, and recent related legislation. It is concluded that the change in the Government contracting environment in recent years should be sufficient incentive for contractors to monitor their operations more closely.

Defense Contracting in Iraq: Issues and Options for Congress

DTIC Science & Technology

2008-05-06

ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12 . DISTRIBUTION/AVAILABILITY STATEMENT Approved for public...contract calls for the three companies to compete for task orders; each company may be awarded up to $5 billion for troop support services per year , the...contracting. The Fiscal Year (FY) 2008 Defense Authorization Act (P.L. 110-181) contains provisions that address contract waste, fraud, abuse, and

Using Data Mining to Detect Health Care Fraud and Abuse: A Review of Literature

PubMed Central

Joudaki, Hossein; Rashidian, Arash; Minaei-Bidgoli, Behrouz; Mahmoodi, Mahmood; Geraili, Bijan; Nasiri, Mahdi; Arab, Mohammad

2015-01-01

Inappropriate payments by insurance organizations or third party payers occur because of errors, abuse and fraud. The scale of this problem is large enough to make it a priority issue for health systems. Traditional methods of detecting health care fraud and abuse are time-consuming and inefficient. Combining automated methods and statistical knowledge lead to the emergence of a new interdisciplinary branch of science that is named Knowledge Discovery from Databases (KDD). Data mining is a core of the KDD process. Data mining can help third-party payers such as health insurance organizations to extract useful information from thousands of claims and identify a smaller subset of the claims or claimants for further assessment. We reviewed studies that performed data mining techniques for detecting health care fraud and abuse, using supervised and unsupervised data mining approaches. Most available studies have focused on algorithmic data mining without an emphasis on or application to fraud detection efforts in the context of health service provision or health insurance policy. More studies are needed to connect sound and evidence-based diagnosis and treatment approaches toward fraudulent or abusive behaviors. Ultimately, based on available studies, we recommend seven general steps to data mining of health care claims. PMID:25560347

Assessment of DoD Wounded Warrior Matters - Wounded Warrior Battalion - West Headquarters and Southern California Units

DTIC Science & Technology

2012-08-22

urine drug tesL~ (UDTs). A BUM ED Publication wi ll follow the lnterim Guidance for sustainment. Two training programs have also been created to...line DEPARTMENT OF DEFENSE 800.424.9098 Fraud, Waste, Mismanagement, Abuse of Authority Suspected Threats to Homeland Security Unauthorized...determined how many Service members were required to be interviewed, then we applied a simple random sample approach to determine the Service members we

Common Violations of the United States Code in Economic Crime Investigations. The Fraud, Waste and Abuse Monster.

DTIC Science & Technology

1983-11-15

person- nel in understanding the elements of the offense and the evidence necessary to establish or negate probable cause. For the benefit of OCONUS...gift, favor, entertainment, hospitality, transportation, loan, or other tangible benefit for which less than fair market value is paid. c...influenced. He may even refuse the offer, yet the offense is complete. Nor need the thing of value personally benefit the public official. However, the

Financial Crisis; Department of Defense Spending: How to Control Fraud, Waste, and Abuse in the Military

DTIC Science & Technology

2012-04-25

problem that continues to cost billions of dollars in losses at a time when the United States Military and Federal Government can least afford it. It...to look like. The federal budget has become the leading issue affecting every Government Agency. The military’s budget is decreasing by more than...discuss the cost savings measures and initiatives currently being debated in Washington, and offer, for debate, several new recommendations that have

17 CFR 48.8 - Conditions of registration.

Code of Federal Regulations, 2013 CFR

2013-04-01

...; prohibit fraud, abuse, and market manipulation and other disruptions of the market; and provide that such... any market manipulation, abuse, fraud, deceit, or conversion or that results in suspension or... continue to satisfy the criteria for a regulated market or licensed exchange pursuant to the regulatory...

17 CFR 48.8 - Conditions of registration.

Code of Federal Regulations, 2014 CFR

2014-04-01

...; prohibit fraud, abuse, and market manipulation and other disruptions of the market; and provide that such... any market manipulation, abuse, fraud, deceit, or conversion or that results in suspension or... continue to satisfy the criteria for a regulated market or licensed exchange pursuant to the regulatory...

17 CFR 48.8 - Conditions of registration.

Code of Federal Regulations, 2012 CFR

2012-04-01

...; prohibit fraud, abuse, and market manipulation and other disruptions of the market; and provide that such... any market manipulation, abuse, fraud, deceit, or conversion or that results in suspension or... continue to satisfy the criteria for a regulated market or licensed exchange pursuant to the regulatory...

Administrative Subpoenas in Criminal Investigations: A Sketch

DTIC Science & Technology

2006-03-17

administrative subpoenas primarily or exclusive for use in a criminal investigation in cases involving health care fraud, child abuse , Secret Service...no explicit prohibition on disclosure of the existence or specifics of a subpoena issued under this authority. Health Care, Child Abuse , and...investigations. It is an amalgam of three relatively recent statutory provisions — one, the original, dealing with health care fraud; one with child abuse offenses

No evidence of the effect of the interventions to combat health care fraud and abuse: a systematic review of literature.

PubMed

Rashidian, Arash; Joudaki, Hossein; Vian, Taryn

2012-01-01

Despite the importance of health care fraud and the political, legislative and administrative attentions paid to it, combating fraud remains a challenge to the health systems. We aimed to identify, categorize and assess the effectiveness of the interventions to combat health care fraud and abuse. The interventions to combat health care fraud can be categorized as the interventions for 'prevention' and 'detection' of fraud, and 'response' to fraud. We conducted sensitive search strategies on Embase, CINAHL, and PsycINFO from 1975 to 2008, and Medline from 1975-2010, and on relevant professional and organizational websites. Articles assessing the effectiveness of any intervention to combat health care fraud were eligible for inclusion in our review. We considered including the interventional studies with or without a concurrent control group. Two authors assessed the studies for inclusion, and appraised the quality of the included studies. As a limited number of studies were found, we analyzed the data using narrative synthesis. The searches retrieved 2229 titles, of which 221 full-text studies were assessed. We found no studies using an RCT design. Only four original articles (from the US and Taiwan) were included: two studies within the detection category, one in the response category, one under the detection and response categories, and no studies under the prevention category. The findings suggest that data-mining may improve fraud detection, and legal interventions as well as investment in anti-fraud activities may reduce fraud. Our analysis shows a lack of evidence of effect of the interventions to combat health care fraud. Further studies using robust research methodologies are required in all aspects of dealing with health care fraud and abuse, assessing the effectiveness and cost-effectiveness of methods to prevent, detect, and respond to fraud in health care.

No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse: A Systematic Review of Literature

PubMed Central

Rashidian, Arash; Joudaki, Hossein; Vian, Taryn

2012-01-01

Background Despite the importance of health care fraud and the political, legislative and administrative attentions paid to it, combating fraud remains a challenge to the health systems. We aimed to identify, categorize and assess the effectiveness of the interventions to combat health care fraud and abuse. Methods The interventions to combat health care fraud can be categorized as the interventions for ‘prevention’ and ‘detection’ of fraud, and ‘response’ to fraud. We conducted sensitive search strategies on Embase, CINAHL, and PsycINFO from 1975 to 2008, and Medline from 1975–2010, and on relevant professional and organizational websites. Articles assessing the effectiveness of any intervention to combat health care fraud were eligible for inclusion in our review. We considered including the interventional studies with or without a concurrent control group. Two authors assessed the studies for inclusion, and appraised the quality of the included studies. As a limited number of studies were found, we analyzed the data using narrative synthesis. Findings The searches retrieved 2229 titles, of which 221 full-text studies were assessed. We found no studies using an RCT design. Only four original articles (from the US and Taiwan) were included: two studies within the detection category, one in the response category, one under the detection and response categories, and no studies under the prevention category. The findings suggest that data-mining may improve fraud detection, and legal interventions as well as investment in anti-fraud activities may reduce fraud. Discussion Our analysis shows a lack of evidence of effect of the interventions to combat health care fraud. Further studies using robust research methodologies are required in all aspects of dealing with health care fraud and abuse, assessing the effectiveness and cost-effectiveness of methods to prevent, detect, and respond to fraud in health care. PMID:22936981

41 CFR 105-53.131 - Office of Inspector General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... functions and established an Office of Inspector General in 11 major domestic departments and agencies... United States Attorneys on all matters relating to the detection and prevention of fraud and abuse. The Inspector General reports semiannually to the Congress through the Administrator concerning fraud, abuses...

Strong Internal Controls at Service Delivery Level Will Help Prevent CETA-Type Fraud and Abuse in Job Training Partnership Act Programs. Report to Senator Sam Nunn, Ranking Minority Member, Permanent Subcommittee on Investigations, Senate Committee on Governmental Affairs.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The Government Accounting Office (GAO) conducted an examination of patterns and causes of fraud in Comprehensive Employment and Training Act (CETA) programs to determine how implementation of Job Training Partnership Act (JTPA) programs might be made less vulnerable to exploitation. GAO's investigation found that fraud and abuse in CETA programs…

Cataract Surgery: Fraud, Waste, and Abuse. A Report by the Chairman of the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This report is a summary of the findings from the Subcommittee on Health and Long-Term Care of the United States House of Representatives Select Committee on Aging investigation of cataract surgery and the use of intraocular lenses (IOL's) in the United States. The document provides background on the definition and treatment of cataracts and…

Administrative Subpoenas and National Security Letters in Criminal and Intelligence Investigations: A Sketch

DTIC Science & Technology

2005-04-15

exclusive for use in a criminal investigation in cases involving health care fraud, child abuse , Secret Service protection, controlled substance cases...explicit prohibition on disclosure of the existence or specifics of a subpoena issued under this authority. Health Care, Child Abuse & Presidential...investigations. It is an amalgam is three relatively recent statutory provisions — one, the original, dealing with health care fraud; one with child abuse offenses

Eliminating waste in US health care.

PubMed

Berwick, Donald M; Hackbarth, Andrew D

2012-04-11

The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste--overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse--the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies.

75 FR 30411 - Privacy Act of 1974; Report of a Modified or Altered System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... Privacy Act of 1974; the Federal Information Security Management Act of 2002; the Computer Fraud and Abuse... Security Management Act of 2002; the Computer Fraud and Abuse Act of 1986; the Health Insurance Portability... systems and data files necessary for compliance with Title XI, Part C of the Social Security Act because...

18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

Research Misconduct: Policy and Practice at the NSF

NASA Astrophysics Data System (ADS)

Manka, Aaron

2004-03-01

Under NSF's Office of Inspector General mandate to prevent fraud, waste, abuse, or mismanagement involving NSF's proposals and awards, our office also investigates allegations of research misconduct. I will discuss our office's handling of such matters, focusing on the ethical and legal obligations of proposal submitters and awardees and the role of the scientific community. To illustrate some other points that are of interest to the physics community, I will also discuss some of our investigative activities relevant to: duplicate funding, the accuracy of information in proposals, and collaborations.

Evaluation of the DoD Safety Program: DoD Guard & Reserve Safety Survey

DTIC Science & Technology

2008-12-12

Alexandria,VA,22350-1500 8 . PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S... 8 -98) Prescribed by ANSI Std Z39-18 hot line D E PA R T M E N T O F D E F E N S E To report fraud, waste, mismanagement, and abuse of authority...Results 2007 Table 1 Percentile Scores, Percent Distribution of Responses, and Average Response Scores - 8 - sse oe LP oe sse SP LP SSA sse

Department of Education's Student Loan Programs: Are Tax Dollars at Risk? Hearing before the Subcommittee on Criminal Justice, Drug Policy, and Human Resources of the Committee on Government Reform. House of Representatives, One Hundred Sixth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Government Reform.

This hearing was held to consider whether the student loan programs of the Department of Education place tax dollars at risk. In his opening remarks, Representative John L. Mica (Florida) pointed out that for nearly 10 years, the U.S. General Accounting Office has labeled these programs as a high risk for fraud, waste, abuse, and mismanagement. In…

Avoiding pharmacy fraud through automation and audit.

PubMed

Tripodi, M

1998-12-01

Pharmacy data offer some of the most reliable and evaluative information in managed care today. As fraud constitutes up to 10% of our total health care expenditures, the author explains how monitoring the pharmacy network for fraud and abuse is an easy way of reclaiming some of these losses.

Special Fraud Alert for Schools, Lenders, and Guarantee Agencies.

ERIC Educational Resources Information Center

Department of Education, Washington, DC.

Guidelines to prevent fraud and abuse in the government's student aid programs are presented for schools, lenders, and guarantee agencies. Student aid fraud is defined as intentional wrongful obtaining of student financial assistance (SFA) benefits through deceptive means. It is noted that falsification of eligibility is the most common form of…

Food Assistance: Efforts To Control Fraud and Abuse in the Child and Adult Care Food Program Should Be Strengthened. United States General Accounting Office Report to Congressional Committees.

ERIC Educational Resources Information Center

Robertson, Robert E.

The Child and Adult Care Food Program provides over $1.5 billion in benefits annually to children and adults in day care. In order to address the longstanding problems of fraud and abuse present in the program, state agencies have been charged with the responsibility for implementing Food and Nutrition Service's (FNS) regulations to prevent and…

Reducing Homeland Insecurities: Ending Abuse of the Asylum and Credible Fear Program

DTIC Science & Technology

2015-03-01

Operations FDNS Fraud Detection and National Security FEMA Federal Emergency Management Agency FY Fiscal Year GAO Government Accounting...file applications. A 2002 Government Accounting Office (GAO) study on benefit fraud found that fraud was pervasive and routinely used in furtherance... Government Accountability Office, 2002), http://www.gao.gov/assets/240/233515.pdf. 7 Mark Motivans, Immigration Offenders in the Federal Justice

42 CFR 455.1 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for a State fraud detection and investigation program, and for disclosure of information on ownership... Security Act, Subpart A provides State plan requirements for the identification, investigation, and referral of suspected fraud and abuse cases. In addition, the subpart requires that the State— (1) Report...

45 CFR 160.203 - General rule and exceptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or... § 160.204 that the provision of State law: (1) Is necessary: (i) To prevent fraud and abuse related to...

45 CFR 160.203 - General rule and exceptions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or... § 160.204 that the provision of State law: (1) Is necessary: (i) To prevent fraud and abuse related to...

45 CFR 160.203 - General rule and exceptions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or... § 160.204 that the provision of State law: (1) Is necessary: (i) To prevent fraud and abuse related to...

45 CFR 160.203 - General rule and exceptions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or... § 160.204 that the provision of State law: (1) Is necessary: (i) To prevent fraud and abuse related to...

45 CFR 160.203 - General rule and exceptions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or... § 160.204 that the provision of State law: (1) Is necessary: (i) To prevent fraud and abuse related to...

Medicare, Medicaid fraud a billion-dollar art form in the US

PubMed Central

Korcok, M

1997-01-01

Medicare and Medicaid fraud costs billions of dollars each year in the US. Investigators have shown that fraud is found in all segments of the health care system. Even though the Canadian system has stricter regulations and tighter controls, can regulators here afford to be complacent about believing that such abuse would not happen here? One province has established an antifraud unit to monitor its health insurance scheme; it already has 1 prosecution under its belt. PMID:9141996

Special Medicare reimbursement and fraud and abuse considerations for management services organizations, medical foundations, and integrated delivery systems.

PubMed

DeMuro, P R; Owens, J F

1994-01-01

This chapter discusses certain Medicare reimbursement and fraud and abuse considerations for management services organizations (MSOs), medical foundations, and integrated delivery systems. It stresses the necessity of a business plan, the sources of capitalization that might be used in creating an integrated delivery system, and their effect on Medicare reimbursement. It also discusses related party principles and considerations and the Medicare "incident to" regulations. Furthermore, it discusses the application of certain Medicare safe harbor regulations on MSOs' structures and services, and those of medical foundations and integrated delivery systems.

Well-planned due diligence can protect buyers of healthcare entities.

PubMed

Doty, L W; Campbell, A T

2000-10-01

Conducting a thorough due diligence is essential for any buyer that plans to acquire a healthcare entity, including a hospital or a group practice, because it provides an opportunity for the buyer to uncover billing or other fraud-and-abuse problems within the selling organization. These problems can be significant, because the buyer can be held liable for undiscovered billing problems that result in investigation, prosecution, and penalties. It is important for the buyer to ascertain who bears the liability of fraud-and-abuse violations and attempt to protect itself from assuming such liability.

20 CFR 632.125 - Responsibilities of Native American grantees, subgrantees and contractors for preventing fraud...

Code of Federal Regulations, 2010 CFR

2010-04-01

... management information system in accordance with the requirements of § 632.32. (c) Any person having..., subgrantees and contractors for preventing fraud and program abuse and for general program management. 632.125... and for general program management. (a) Each Native American grantee shall establish and use internal...

76 FR 82028 - Request for Information for the 2012 Trafficking in Persons Report

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... equally and adequately to victims of labor and sex trafficking? Men, women, and children? Citizen and... therefore not seeking, information on prostitution, human smuggling, visa fraud, or child abuse, unless such... any act of sex trafficking involving force, fraud, coercion, or in which the victim of sex trafficking...

Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations. Extension of temporary moratoria.

PubMed

2017-07-28

This document announces the extension of statewide temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers and Medicare home health agencies, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey, as applicable, to prevent and combat fraud, waste, and abuse. This extension also applies to the enrollment of new non-emergency ground ambulance suppliers and home health agencies, subunits, and branch locations in Medicaid and the Children's Health Insurance Program in those states.

Interventional pain management at crossroads: the perfect storm brewing for a new decade of challenges.

PubMed

Manchikanti, Laxmaiah; Singh, Vijay; Boswell, Mark V

2010-01-01

The health care industry in general and care of chronic pain in particular are described as recession-proof. However, a perfect storm with a confluence of many factors and events -none of which alone is particularly devastating - is brewing and may create a catastrophic force, even in a small specialty such as interventional pain management. Multiple challenges related to interventional pain management in the current decade will include individual and group physicians, office practices, ambulatory surgery centers (ASCs), and hospital outpatient departments (HOPD). Rising health care costs are discussed on a daily basis in the United States. The critics have claimed that health outcomes are the same as or worse than those in other countries, but others have presented the evidence that the United States has the best health care system. All agree it is essential to reduce costs. Numerous factors contribute to increasing health care costs. They include administrative costs, waste, abuse, and fraud. It has been claimed the U.S. health care system wastes up to $800 billion a year. Of this, fraud accounts for approximately $200 billion a year, involving fraudulent Medicare claims, kickbacks for referrals for unnecessary services, and other scams. Administrative inefficiency and redundant paperwork accounts for 18% of health care waste, whereas medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11% of the total. Further, American physicians spend nearly 8 hours per week on paperwork and employ 1.66 clerical workers per doctor, more than any other country. It has been illustrated that it takes $60,000 to $88,000 per physician per year, equal to one-third of a family practitioner's gross income, and $23 to $31 billion each year in total to interact with health insurance plans. The studies have illustrated that an average physician spends $68,274 per year communicating with insurance companies and performing other non-medical functions. For an office-based practice, the overall total in the United States is $38.7 billion, or $85,276 per physician. In the United States there are 2 types of physician payment systems: private health care and Medicare. Medicare has moved away from the Medicare Economic Index (MEI) and introduced the sustainable growth rate (SGR) formula which has led to cuts in physician payments on a yearly basis. In 2010 and beyond into the new decade, interventional pain management will see significant changes in how we practice medicine. There is focus on avoiding waste, abuse, fraud, and also cutting costs. Evidence-based medicine (EBM) and comparative effectiveness research (CER) have been introduced as cost-cutting and rationing measures, however, with biased approaches. This manuscript will analyze various issues related to interventional pain management with a critical analysis of physician payments, office facility payments, and ASC payments by various payor groups.

Mooring in safe harbors. Proposed rules set out what's legal, what's not under Medicare fraud and abuse laws.

PubMed

MacKelvie, C F; Sanborn, A B

1989-04-01

The 1977 Fraud and Abuse Amendments, which prohibit business relationships that increase Medicare utilization, have created uncertainty among healthcare providers as to which commercial arrangements are legal and which are not. In response to this uncertainty, Congress enacted the Medicare and Medicaid Patient and Program Protection Act of 1987, which required the Department of Health and Human Services to develop regulations that would specify allowable practices. The regulations proposed Jan. 23, 1989, specify "safe harbors" from criminal and civil penalties in the following areas: sales of physician practices, rental agreements, investments by providers, and personal services and management contracts. In addition, the Fraud and Abuse Amendments exempted referrals arising out of a bona fide employment relationship, properly disclosed discounts, and group purchasing arrangements. The proposed regulations attempt to clarify these exemptions. Unfortunately, the proposals do little to calm a healthcare industry that is jumpy about which transactions are permitted and which are not. This is partly because the Internal Revenue Service, Health and Human Services, and the Department of Justice often issue conflicting pronouncements regarding prohibited business transactions by tax-exempt providers.

Financial Fraud and Child Abuse

ERIC Educational Resources Information Center

Little, Allison Dare

2014-01-01

A modern form of abuse of children by parents and foster parents is to use the identity of children in their care for their own financial benefit, such as accessing their unused social security numbers to secure credit. This article reviews examples and implications of this identity theft.

75 FR 37287 - Privacy Act Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

...The Recovery Accountability and Transparency Board (Board) amends its regulations implementing the Privacy Act of 1974 (Privacy Act), Public Law 93-579, 5 U.S.C. 552a. This final rule adds 4 CFR 200.17 to exempt certain systems of records from certain sections of the Privacy Act (5 U.S.C. 552a) pursuant to 5 U.S.C. 552a(j) and (k). These exemptions will help ensure that the Board may efficiently and effectively compile investigatory material to prevent and detect fraud, waste, and abuse and perform its other authorized duties and activities relating to oversight of funds awarded pursuant to the American Recovery and Reinvestment Act of 2009, Public Law 111-5 (Feb. 17, 2009) (Recovery Act).

Fraud and abuse. Building an effective corporate compliance program.

PubMed

Matusicky, C F

1998-04-01

In 1997, General Health System (GHS), a not-for-profit integrated delivery system headquartered in Baton Rouge, Louisiana, developed a formal corporate compliance program. A newly appointed corporate compliance officer worked with key GHS managers and employees to assess the organization's current fraud and abuse prevention practices and recommend changes to meet new regulatory and organizational requirements. Then a structure for implementing these changes was developed, with staff training at its core. The program required a significant initial outlay of financial and human resources. The benefits to the organization, however, including a greater ability to respond quickly and effectively to possible compliance problems and better organizational communications, were worth the investment.

7 CFR 3565.505 - Liability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... GUARANTEED RURAL RENTAL HOUSING PROGRAM Agency Guaranteed Loans That Back Ginnie Mae Guaranteed Securities... limited to, negligence, fraud, abuse, misrepresentation or misuse of funds, property condition, or...

Using support vector machines to detect medical fraud and abuse.

PubMed

Francis, Charles; Pepper, Noah; Strong, Homer

2011-01-01

This paper examines the architecture and efficacy of Quash, an automated medical bill processing system capable of bill routing and abuse detection. Quash is designed to be used in conjunction with human auditors and a standard bill review software platform to provide a complete cost containment solution for medical claims. The primary contribution of Quash is to provide a real world speed up for medical fraud detection experts in their work. There will be a discussion of implementation details and preliminary experimental results. In this paper we are entirely focused on medical data and billing patterns that occur within the United States, though these results should be applicable to any financial transaction environment in which structured coding data can be mined.

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of Federal financial participation--HCFA. Final rule.

PubMed

1985-07-30

This final rule provides the additional requirements to the conditions and procedures for initial approval and reapproval of Medicaid Management Information Systems (MMIS) that were added by section 1903(r) of the Social Security Act (as amended by section 901 of the Mental Health Systems Act of 1980, Pub. L. 96-398). These provisions are intended to improve States' MMIS, ensure efficient system operations, and make the procedures for detection of fraud, waste, and abuse more effective. In addition, this final rule specifies the procedures we follow in reducing the level of Federal financial participation in State administrative expenditures if a State fails to meet the conditions for initial operation, initial approval, or reapproval of an MMIS.

Medicare

MedlinePlus

... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Sign Up / Change Plans ...

Alaska Department of Law

Science.gov Websites

Attorney General Opinions Executive Branch Ethics Criminal Justice Alaska Medicaid Fraud Control Anchorage Abuse Executive Branch Ethics Law Resources Public Safety Action Plan Federal Issues and Conflicts - PDF

Corporate compliance: critical to organizational success.

PubMed

Cantone, L

1999-01-01

Operation Restore Trust (ORT) has focused increased governmental attention on health care fraud and abuse activities, making it more costly to be noncompliant, and thus has led to significant behavioral changes within the health care industry. Initially five states (California, Florida, Illinois, New York, & Texas) were included in the 1997 ORT pilot program. This has been expanded to include Arizona, Colorado, Georgia, Louisiana, Massachusetts, Missouri, New Jersey, Ohio, Pennsylvania, Tennessee, Virginia, and Washington. The author presents a road map for developing of a compliance program that includes suggested strategies for staff training in anticipation of heightened scrutiny of compliance standards and procedures. Effective Corporate Compliance Programs (CCPs) should include policies and procedures and monitoring systems that can provide reasonable assurance that fraud, abuse, and systematic billing errors are detected in a timely manner.

Abuses in Federal Student Grant Programs: Proprietary School Abuses. Hearing before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs. United States Senate, One Hundred Fourth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

The purpose of this hearing was to probe a pattern of fraud and abuse in the Pell Grant Program for postsecondary students, focusing specifically on the IADE American Schools, a for-profit vocational school with campuses in the Los Angeles (California) area and serving primarily Hispanic students. In his opening remarks Senator Roth detailed a…

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... identified as an overpayment regardless of recoupment from such providers, within 60 days of discovery of the...

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of federal financial participation--Health Care Financing Administration. Proposed rule.

PubMed

1983-03-03

This proposal adds to regulations new conditions and procedures for initial approval and for reapproval of Medicaid Management Information Systems (MMIS) to update the regulations to reflect additional requirements added by section 901 of the Mental Health Systems Act of 1980 (Pub. L. 96-398). The proposal specifies procedures for reducing the level of Federal financial participation in a State's administrative expenditures when a State fails to meet the conditions for initial operation, initial approval or reapproval of an MMIS. It also proposes procedures with respect to waivers of the conditions of approval and reapproval and to appeals of adverse decisions. These provisions are intended to improve States' MMIS, and to ensure efficient system operations, and to detect cases of fraud, waste, and abuse effectively.

NSF's Handling of Allegations of Misconduct in Science

NASA Astrophysics Data System (ADS)

Manka, Aaron

2000-03-01

Under NSF's Office of Inspector General mandate to prevent fraud, waste, abuse, or mismanagement involving NSF's proposals and awards, our office is unique in that it also investigates allegations of misconduct in science. I will discuss our office's handling of such matters, focusing on the ethical and legal obligations of proposal submitters and awardees and the role of the scientific community. To illustrate some of these points that are of interest to the physics community, I will discuss some of our investigative activities relevant to: duplicate funding, cost sharing, and the accuracy of information in proposals. If the OSTP policy on research misconduct has been released for public comment, I will briefly discuss this policy, which is meant to be adopted by all federal funding agencies, and what it will mean for us and the community we serve.

42 CFR 438.1 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... strategy; (v) Specifies certain prohibitions aimed at the prevention of fraud and abuse; (vi) Provides that... depending on the type of entity and on the authority under which the State contracts with the entity...

42 CFR 438.1 - Basis and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... strategy; (v) Specifies certain prohibitions aimed at the prevention of fraud and abuse; (vi) Provides that... depending on the type of entity and on the authority under which the State contracts with the entity...

Children and End-State Renal Disease (ERSD)

MedlinePlus

... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... last 3 years by working and paying Social Security taxes. You (or your spouse) are getting, or ...

The fraud and abuse statute and investor-owned ambulatory surgery centers.

PubMed

Becker, Scott; Harned, Nicholas

2002-04-01

The growth in the number of ambulatory surgery centers, coupled with the unique guidance provided by the OIG in this area, provide a fascinating legal and regulatory environment for ambulatory surgery centers.

Foreclosure Fraud and Homeowner Abuse Prevention Act of 2011

THOMAS, 112th Congress

Sen. Brown, Sherrod [D-OH

2011-04-14

Senate - 04/14/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

20 CFR 667.630 - How are complaints and reports of criminal fraud and abuse addressed under WIA?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Grievance Procedures, Complaints, and State Appeals Processes § 667.630 How are complaints and reports of...

Elder Fraud and Financial Exploitation: Application of Routine Activity Theory.

PubMed

DeLiema, Marguerite

2017-03-10

Elder financial exploitation, committed by individuals in positions of trust, and elder fraud, committed by predatory strangers, are two forms of financial victimization that target vulnerable older adults. This study analyzes differences between fraud and financial exploitation victims and tests routine activity theory as a contextual model for victimization. Routine activity theory predicts that criminal opportunities arise when a motivated offender and suitable target meet in the absence of capable guardians. Fifty-three financial exploitation and fraud cases were sampled from an elder abuse forensic center. Data include law enforcement and caseworker investigation reports, victim medical records, perpetrator demographic information, and forensic assessments of victim health and cognitive functioning. Fraud and financial exploitation victims performed poorly on tests of cognitive functioning and financial decision making administered by a forensic neuropsychologist following the allegations. Based on retrospective record review, there were few significant differences in physical health and cognitive functioning at the time victims' assets were taken, although their social contexts were different. Significantly more fraud victims were childless compared with financial exploitation victims. Fraud perpetrators took advantage of elders when they had no trustworthy friends or relatives to safeguard their assets. Findings support an adapted routine activity theory as a contextual model for financial victimization. Fraud most often occurred when a vulnerable elder was solicited by a financial predator in the absence of capable guardians. Prevention efforts should focus on reducing social isolation to enhance protection. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

NPS Government Purchase Card Program: An Analysis of Internal Controls

DTIC Science & Technology

2014-03-01

approving official APC agency program coordinator CCPMD Consolidated Card Program Management Division CH cardholder COSO Committee of Sponsoring...correct, and minimize fraud, waste, and abuse” (DPAP, 2011, p. 2-2). To minimize risks , the management and internal controls should have support from...three interrelated subjects: enterprise risk management (ERM), internal control, and fraud deterrence” (para. 6). The 23 five components of an

Criminal investigations and the Superfund program. Fact sheet (Final)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1990-09-01

The fact sheet, directed toward any one who witnesses fraudulent activity in EPA programs, discusses areas in which fraud and abuse can occur and provides an understanding of the criminal investigation process that results from reports of suspicious activity.

42 CFR 420.405 - Rewards for information relating to Medicare fraud and abuse.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., information leading to a recovery of Medicare funds is not eligible to receive a reward under this section... change in his or her address or other relevant personal information (for example, change of name, phone...

78 FR 9393 - Delegation of Authorities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... under Section 1128C(a)(2) of the Social Security Act (the Act) (42 U.S.C. 1320a-7c(a)(2)), as amended... to the Health Care Fraud and Abuse Control Program created by Section 201(a) of the Health Insurance...

42 CFR 420.405 - Rewards for information relating to Medicare fraud and abuse.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., information leading to a recovery of Medicare funds is not eligible to receive a reward under this section... change in his or her address or other relevant personal information (for example, change of name, phone...

Combating fraud in health care: an essential component of any cost containment strategy.

PubMed

Morris, Lewis

2009-01-01

Federal health care programs, including Medicare and Medicaid, are under attack by dishonest people who lie to the government and exploit its programs to steal taxpayers' money. The full extent of health care fraud cannot be measured precisely. However, the Federal Bureau of Investigation (FBI) estimates that fraudulent billings to public and private health care programs are 3-10 percent of total health spending, or $75-$250 billion in fiscal year 2009. Successful efforts to stop such abuses, without unduly burdening legitimate providers, require aggressive, innovative, and sustained attention to protect taxpayers and beneficiaries.

Energy entrepreneurs who bilked the public

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barnes, E.

1982-11-01

The rush to invest in domestic energy development was accompanied by fraud, which has cost victims financial loss and diverted needed capital from legitimate projects. Government policies and tax incentives encouraged greedy entrepreneurs to perpetrate energy-related frauds. The three major areas targeted for abuse were tax shelters, deferred delivery contracts, and securities in companies promoting energy-related products. The courts have been lenient in the conviction and punishment of unlawful promoters, while victims who risk losing tax deductions are often reluctant to cooperate. Several case histories illustrate the activities of con artists and the rewards available to the unscrupulous. (DCK)

45 CFR 96.84 - Miscellaneous.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Program § 96.84 Miscellaneous. (a) Rights and responsibilities of territories. Except as otherwise provided, a territory eligible for funds shall have the same rights and responsibilities as a State. (b..., fraud, and abuse. Grantees must establish appropriate systems and procedures to prevent, detect, and...

Double-Entry Bookkeeping.

ERIC Educational Resources Information Center

Snyder, Herbert

1999-01-01

Explains the principles and mechanics of double-entry bookkeeping as a part of the accounting cycle to produce a functioning set of accounting records. Suggests that libraries need to have accurate and timely information about their spending to gain financial control and protect against fraud and abuse. (LRW)

Multinational Quality Assurance

ERIC Educational Resources Information Center

Kinser, Kevin

2011-01-01

Multinational colleges and universities pose numerous challenges to the traditional models of quality assurance that are designed to validate domestic higher education. When institutions cross international borders, at least two quality assurance protocols are involved. To guard against fraud and abuse, quality assurance in the host country is…

The paper monster. Corporate compliance and the board.

PubMed

Hinrichsen, C A; Capobianco, C; Diamond, M

2001-02-01

Fraud and abuse lawsuits and settlements are getting bigger, and the DOJ shows no signs of letting up on its scrutiny of health care organizations. That's why a strong compliance program is your best defense, and it all starts with the board.

Abuses in Federal Student Grant Programs. Hearings before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred Third Congress, First Session (October 27-28, 1993).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

It appears that many of the problems plaguing the Federal Student Aid Programs are also undermining the Pell Grant program, not so much from dishonesty on the part of students, but by dishonesty on the part of schools. This document presents testimony and prepared statements concerning the allegations of fraud, abuse, and mismanagement in the…

Prescription drug abuse: problem, policies, and implications.

PubMed

Phillips, Janice

2013-01-01

This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing. Copyright © 2013. Published by Mosby, Inc.

Computer-aided auditing of prescription drug claims.

PubMed

Iyengar, Vijay S; Hermiz, Keith B; Natarajan, Ramesh

2014-09-01

We describe a methodology for identifying and ranking candidate audit targets from a database of prescription drug claims. The relevant audit targets may include various entities such as prescribers, patients and pharmacies, who exhibit certain statistical behavior indicative of potential fraud and abuse over the prescription claims during a specified period of interest. Our overall approach is consistent with related work in statistical methods for detection of fraud and abuse, but has a relative emphasis on three specific aspects: first, based on the assessment of domain experts, certain focus areas are selected and data elements pertinent to the audit analysis in each focus area are identified; second, specialized statistical models are developed to characterize the normalized baseline behavior in each focus area; and third, statistical hypothesis testing is used to identify entities that diverge significantly from their expected behavior according to the relevant baseline model. The application of this overall methodology to a prescription claims database from a large health plan is considered in detail.

PubMed Central

Brown, J. B.; Schmidt, G.; Lent, B.; Sas, G.; Lemelin, J.

2001-01-01

OBJECTIVE: To replicate, in a Francophone community, our prior work determining the reliability and validity of the full Woman Abuse Screening Tool (WAST) and a two-item version (WAST-Short). DESIGN: Questionnaires completed by abused and nonabused women. SETTING: Two women's shelters in Francophone communities in Ontario and Quebec and participants' homes or workplaces. PARTICIPANTS: A convenience sample of 25 abused women currently residing in two women's shelters and a convenience sample of 21 women who reported they were not abused. MAIN OUTCOME MEASURES: Women's responses to French versions of the WAST, the Abuse Risk Inventory (ARI), and comfort in answering the questions were compared. Also, the reliability and validity of French versions of WAST and WAST-Short were assessed. RESULTS: Abused (n = 23) and not abused (n = 21) women were demographically similar. A strong single-factor structure that accounted for 81% of total variance in the French WAST items was identified. The French WAST was found to be highly reliable with a coefficient alpha of .95 and demonstrated construct and discriminant validity. The WAST-Short correctly classified all the nonabused women and 78.7% of the abused women. The abused women reported feeling less comfortable responding to the WAST questions than the nonabused women. CONCLUSION: The French version of the WAST demonstrated good reliability and validity and discriminated between known samples of abused and nonabused women. Even though the French WAST-Short did not perform as well as the English version, results of this study support further evaluation of the WAST for screening women in Francophone or bilingual family practice settings. PMID:11398732

30 CFR 229.123 - Standards for audit activities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... performed under a delegation of authority. (1) General standards—(i) Qualifications. The auditors assigned...) Independence. In all matters relating to the audit work, the audit organization and the individual auditors... evaluation. Auditors should be alert to situations or transactions that could be indicative of fraud, abuse...

Reinventing the Department of Education: Real Regulatory Reform.

ERIC Educational Resources Information Center

Bob, Sharon

1995-01-01

Department of Education regulations and initiatives designed to address problems of fraud, abuse, and loan default in federal student aid programs are examined. The scope and intrusiveness of some recent regulations are criticized, and unintended effects are noted, including increased administrative burdens on all institutions. (Author/MSE)

20 CFR 632.116 - Conflict of interest.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Conflict of interest. 632.116 Section 632.116... EMPLOYMENT AND TRAINING PROGRAMS Prevention of Fraud and Program Abuse § 632.116 Conflict of interest. (a) No... contractor shall avoid personal and organizational conflict of interest in awarding financial assistance and...

The Stark truth: what your physician clients should know about Stark Law and the Anti-Kickback Statute.

PubMed

Taormina, Melissa

2013-01-01

This article summarizes key features of Stark Law and the Anti-Kickback Statute, statutes used to fight health care fraud and abuse within Medicare and Medicaid, and explains how attorneys can help health care providers comply with these laws.

32 CFR 199.9 - Administrative remedies for fraud, abuse, and conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-07-01

... actually furnished by a licensed social worker, psychiatric nurse, or marriage and family counselor); or (v... titles XVIII and XIX of the Social Security Act, Federal Workmen's Compensation, and the Federal... media. (A) Adequate evidence is any information sufficient to support the reasonable belief that a...

32 CFR 199.9 - Administrative remedies for fraud, abuse, and conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-07-01

... actually furnished by a licensed social worker, psychiatric nurse, or marriage and family counselor); or (v... titles XVIII and XIX of the Social Security Act, Federal Workmen's Compensation, and the Federal... media. (A) Adequate evidence is any information sufficient to support the reasonable belief that a...

32 CFR 199.9 - Administrative remedies for fraud, abuse, and conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-07-01

... actually furnished by a licensed social worker, psychiatric nurse, or marriage and family counselor); or (v... titles XVIII and XIX of the Social Security Act, Federal Workmen's Compensation, and the Federal... media. (A) Adequate evidence is any information sufficient to support the reasonable belief that a...

32 CFR 199.9 - Administrative remedies for fraud, abuse, and conflict of interest.

Code of Federal Regulations, 2010 CFR

2010-07-01

... actually furnished by a licensed social worker, psychiatric nurse, or marriage and family counselor); or (v... titles XVIII and XIX of the Social Security Act, Federal Workmen's Compensation, and the Federal... media. (A) Adequate evidence is any information sufficient to support the reasonable belief that a...

32 CFR 199.9 - Administrative remedies for fraud, abuse, and conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-07-01

... actually furnished by a licensed social worker, psychiatric nurse, or marriage and family counselor); or (v... titles XVIII and XIX of the Social Security Act, Federal Workmen's Compensation, and the Federal... media. (A) Adequate evidence is any information sufficient to support the reasonable belief that a...

78 FR 14625 - National Consumer Protection Week, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... Security Proclamation 8939--100th Anniversary of the United States Department of Labor Order of March 1..., we established a new unit to combat fraud and investigate the abusive lending and mortgage packaging... across the Federal Government joined with consumer advocates to launch www.NCPW.gov , an online resource...

20 CFR 668.630 - What are the requirements for preventing fraud and abuse under section 166?

Code of Federal Regulations, 2010 CFR

2010-04-01

... member, or to a member of his or her immediate family, in accordance with 20 CFR 667.200(a)(4) and 29 CFR... them may select or authorize services to any participant who is such a person's husband, wife, father...

Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations. Extension of temporary moratoria.

PubMed

2018-01-30

This document announces the extension of statewide temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers and Medicare home health agencies, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey, as applicable, to prevent and combat fraud, waste, and abuse. This extension also applies to the enrollment of new non-emergency ground ambulance suppliers and home health agencies, subunits, and branch locations in Medicaid and the Children's Health Insurance Program in those states. For purposes of these moratoria, providers that were participating as network providers in one or more Medicaid managed care organizations prior to January 1, 2018 will not be considered "newly enrolling" when they are required to enroll with the State Medicaid agency pursuant to a new statutory requirement, and thus will not be subject to the moratoria.

Security risks in nuclear waste management: Exceptionalism, opaqueness and vulnerability.

PubMed

Vander Beken, Tom; Dorn, Nicholas; Van Daele, Stijn

2010-01-01

This paper analyses some potential security risks, concerning terrorism or more mundane forms of crime, such as fraud, in management of nuclear waste using a PEST scan (of political, economic, social and technical issues) and some insights of criminologists on crime prevention. Nuclear waste arises as spent fuel from ongoing energy generation or other nuclear operations, operational contamination or emissions, and decommissioning of obsolescent facilities. In international and EU political contexts, nuclear waste management is a sensitive issue, regulated specifically as part of the nuclear industry as well as in terms of hazardous waste policies. The industry involves state, commercial and mixed public-private bodies. The social and cultural dimensions--risk, uncertainty, and future generations--resonate more deeply here than in any other aspect of waste management. The paper argues that certain tendencies in regulation of the industry, claimed to be justified on security grounds, are decreasing transparency and veracity of reporting, opening up invisible spaces for management frauds, and in doing allowing a culture of impunity in which more serious criminal or terrorist risks could arise. What is needed is analysis of this 'exceptional' industry in terms of the normal cannons of risk assessment - a task that this paper begins. Copyright 2009 Elsevier Ltd. All rights reserved.

20 CFR 632.124 - Theft or embezzlement from employment and training funds; improper inducement; obstruction of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Theft or embezzlement from employment and training funds; improper inducement; obstruction of investigations and other criminal provisions. 632.124... NATIVE AMERICAN EMPLOYMENT AND TRAINING PROGRAMS Prevention of Fraud and Program Abuse § 632.124 Theft or...

77 FR 62059 - Privacy Act of 1974, as Amended; Revisions to Existing Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... and forms, microfilm or microfiche, and in computer processable storage media such as personnel system... 1974; the Federal Information Security Management Act of 2002; the Computer Fraud and Abuse Act of 1986... apply: The Privacy Act of 1974; the Federal Information Security Management Act of 2002; the Computer...

10 CFR 1.12 - Office of the Inspector General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... General § 1.12 Office of the Inspector General. The Office of the Inspector General— (a) Develops policies... impact on economy and efficiency in the administration of NRC's programs and operations; (g) Keeps the... matters relating to the promotion of economy and efficiency and the detection of fraud and abuse in...

78 FR 79201 - Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... interoperable electronic health records software or information technology and training services. The final rule... information technology and training services necessary and used predominantly to create, maintain, transmit... ordering of, any good, facility, service, or item reimbursable by any Federal health care program. Because...

3 CFR 8782 - Proclamation 8782 of March 5, 2012. National Consumer Protection Week, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

..., mortgages, and student loans, to build the foundation for a better tomorrow. These tools help bring our aspirations within reach and empower countless individuals to earn an education, afford a home, or raise a... highlighting the ways individuals and families can protect themselves from scams, fraud, and abuse. Robust...

State Student Incentive Grant Program: Issues in Partnership.

ERIC Educational Resources Information Center

Lee, John; And Others

Some of the issues concerning the evolving relationship between state and federal agencies in the field of student financial aid are examined, with attention to the State Student Incentive Grant Program (SSIG). After tracing the history of the SSIG, the following issues are considered: SSIG portability; state control of fraud, abuse, and error;…

The Rising of Phoenix, and What It Means for Higher Education

ERIC Educational Resources Information Center

Cronin, Joseph M.; Bachorz, Patricia M.

2005-01-01

Academic leaders are not sure how to deal with for-profit universities, especially those that offer degrees online. One perspective is that they may disappear, victims of criticism, fraud, and abuse. However, thoughtful analysts believe that an Internet revolution is transforming higher education worldwide. If that is true, educators had better…

Crime and Crime Management in Nigeria Tertiary Institutions

ERIC Educational Resources Information Center

Adebanjo, Margaret Adewunmi

2014-01-01

This paper examines crime and its management in Nigerian tertiary institutions. Tertiary institutions today have become arenas for crime activities such as rape, cultism, murder, theft, internet fraud, drug abuse, and examination malpractices. This paper delves into what crime is, and its causes; and the positions of the law on crime management.…

Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Civil Monetary Penalty Rules. Final rule.

PubMed

2016-12-07

This final rule amends the civil monetary penalty (CMP or penalty) rules of the Office of Inspector General to incorporate new CMP authorities, clarify existing authorities, and reorganize regulations on civil money penalties, assessments, and exclusions to improve readability and clarity.

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

78 FR 21314 - Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... health records software or information technology and training services. The final rule for this safe... health records software or information technology and training services. In the same issue of the Federal..., licenses, and intellectual property related to electronic health records software; connectivity services...

Speaking of sex workers: How suppression of research has distorted the United States' domestic HIV response.

PubMed

Forbes, Anna

2015-05-01

Sex workers remain a vulnerable population at risk for HIV acquisition and transmission. Research suggests that interventions at the individual level, such as condom distribution, are less effective in preventing HIV among sex workers than structural changes such as allowing safer work settings and reducing the harassment and abuse of sex workers by clients and police. In the US, HIV incidence has not declined in the last decade. This may be due in part to its policy of wilful ignorance about sex work, but the data to resolve the question simply do not exist. Political actions such as PEPFAR's prostitution pledge and a congressional campaign against "waste, fraud and abuse" in research are products of an ideological environment that suppresses research on HIV prevention and treatment needs of sex workers. Even basic prevalence data are missing because there is no "sex worker" category in the US National HIV Behavior Surveillance System. However, international efforts are taking a public health approach and are calling for decriminalization of sex work, as the most effective public health strategy for reducing HIV incidence among sex workers. Although such an approach is not yet politically feasible in the US, some urgent practical policy changes can be implemented to improve data collection and generation of evidence to support HIV prevention and treatment programs targeting sex workers. Copyright © 2015. Published by Elsevier Ltd.

42 CFR 480.137 - Disclosure to Federal and State enforcement agencies responsible for the investigation or...

Code of Federal Regulations, 2010 CFR

2010-10-01

... agencies responsible for the investigation or identification of fraud or abuse of the Medicare or Medicaid programs. 480.137 Section 480.137 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Medicare or Medicaid programs. (a) Required disclosure. Except as specified in §§ 480.139(a) and 480.140...

Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Exclusion Authorities. Final rule.

PubMed

2017-01-12

This final rule amends the regulations relating to exclusion authorities under the authority of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS or the Department). The final rule incorporates statutory changes, early reinstatement provisions, and policy changes, and clarifies existing regulatory provisions.

77 FR 28876 - Information Collections Being Submitted for Review and Approval to the Office of Management and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... description of the applicant's organizational structure, and the names of its executives, officers, members of.... Title: Structure and Practices of the Video Relay Service Program, Second Report and Order and Order, CG... prevent fraud and abuse, and ensure quality service, in the provision of Internet-based forms of...

Home health, long-term care, and other compliance activities.

PubMed

Anderson, T D; Sadoff, J W

1999-04-01

The Federal government continues to crack down on fraud and abuse in the healthcare industry with such initiatives and tools as Operation Restore Trust and intermediate tax sanctions. Home health and long-term care organizations are the latest entities under study by the Office of Inspector General, and the result of these studies likely will be more antifraud and abuse measures being taken against these entities. All healthcare organizations should pay particular attention to their tax risk exposure. Healthcare organizations that put effective compliance programs in place should be able to reduce the overall risk of challenges to their financial practices.

48 CFR 1342.102-70 - Interagency contract administration and audit services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... on the following types of contracts valued at $500,000 and above: (1) Cost-reimbursement type... is some evidence of fraud or waste; (2) The contractor's performance under the contract has been...

77 FR 4321 - Sunshine Act Meeting; Open Commission Meeting; January 31, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

... Americans while minimizing the universal service contribution burden, including by eliminating waste, fraud... print/ type; digital disk; and audio and video tape. Best Copy and Printing, Inc. may be reached by...

Pre-Service Teachers Attitudes Towards a Career in Special Education in the United Arab Emirate

ERIC Educational Resources Information Center

Naggar Gaad, Eman El.

2004-01-01

The reasons for moving from paper coupons to delivering food stamps electronically include potential reduction in the cost of administering the system and in fraud, theft and abuse of the system. Furthermore, the use of EBT is believed o reduce social stigma and embarrassment felt by recipients when using paper coupon. Therefore, using survey data…

Security & Privacy Policy - Naval Oceanography Portal

Science.gov Websites

Notice: This is a U.S. Government Web Site 1. This is a World Wide Web site for official information information on this Web site are strictly prohibited and may be punishable under the Computer Fraud and Abuse Information Act (FOIA) | External Link Disclaimer This is an official U.S. Navy web site. Security &

77 FR 38067 - Medicare Program; Public Meeting Regarding Inherent Reasonableness of Medicare Fee Schedule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... forth in 42 CFR 414.402 will be used to determine what items will be included in the competitions. These..., regardless of the method of delivery. Non-Mail Order Item--Any item that a beneficiary or caregiver picks up... what Medicare pays for mail order supplies versus non-mail order supplies may encourage fraud and abuse...

Office of Inspector General; Medicare and state health care programs: fraud and abuse; issuance of advisory opinions by the OIG. Final rule.

PubMed

2008-07-17

OIG is adopting in final form, without change, an interim final rule published on March 26, 2008 (73 FR 15937). We received no comments to the interim final rule. The interim final rule revised the process for advisory opinion requestors to submit payments for advisory opinion costs.

Five Years of HHS Home Health Care Evaluations: Using Evaluation to Change National Policy

ERIC Educational Resources Information Center

Brandon, Paul R.; Smith, Nick L.; Grob, George F.

2012-01-01

In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare home health care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the…

Combating healthcare corruption and fraud with improved global health governance.

PubMed

Mackey, Tim K; Liang, Bryan A

2012-10-22

Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of "global health corruption" and development of a treaty protocol to combat this crucial issue.

Corporate integrity agreements: making the best of a tough situation.

PubMed

Ramsey, Robert B

2002-03-01

Healthcare providers increasingly are entering into corporate integrity agreements as part of settlements with the Federal government in fraud-and-abuse cases. Providers pursue these settlements to avoid the costs of defending themselves against fraud charges. However, the costs relating to the long-term compliance activity mandated in the settlement's corporate integrity agreement also can be substantial. These costs include significant staff resources that must be devoted to compliance efforts demanded by the agreement and the required engagement of consultants to monitor the organization's compliance. Healthcare financial managers should be familiar with the elements of a typical corporate integrity agreement and understand strategies for negotiating such an agreement. Effective negotiations can help minimize the organization's costs of compliance with the agreement and facilitate its ongoing implementation of the agreement.

The Office of Inspector General (OIG)

NASA Technical Reports Server (NTRS)

Macisco, Christopher A.

2004-01-01

The NASA Office of Inspector General is the Federal Law Enforcement Agency at NASA which conducts criminal and regulatory investigations in which NASA is a victim. The OIG prevents and detects crime, fiaud, waste and abuse and assists NASA management in promoting economy, efficiency, and effectiveness in its programs and operations. Investigations (OI) and the Office of Audits (OA). The investigations side deals with criminal Investigations, administrative investigations, and civil investigations. The Audits side deals with inspections and assessments as well as the Auditing of NASA Programs and Activities. Our mission at the OIG is to conduct and supervise independent and objective audits and investigations relating to agency programs and operations; to promote economy, effectiveness and efficiency within the agency; to prevent and detect crime, fraud, waste and abuse in agency programs and operations; to review and make recommendations regarding existing and proposed legislation and regulations relating to agency programs and operations. We are also responsible for keeping the agency head and the Congress fully and currently informed of problems in agency programs and operations. deal with False Claims, False Statements, Conspiracy, Theft, Computer Crime, Mail Fraud, the Procurement Integrity Act, the Anti-Kickback Act, as well as noncompliance with NASA Management Instructions, the Federal Acquisition Regulations (FAR), and the Code of Federal Regulations (CFR). Most of the casework that is dealt with in our office is generated through gum shoe work or cases that we generate on our own. These cases can come from Law Enforcement Referrals, GIDEP Reports, EPlMS (NASA Quality System), Defense Contract Audit Agency, Newspaper Articles, and Confidential Information. In many cases, confidentiality is the biggest factor to informants coming forward. We are able to maintain confidentiality because the 01 is independent of NASA Management and doesn t report to the Center Directors, therefore the informant s mangers and supervisors are unaware of the informants actions. The only time when an informant s confidentiality may be compromised is when it is needed in a Court of Law and is released through a Judicial Court Order. During my tenure here at the NASA OIG/OI at Glenn Research Center, I have been involved in many different tasks. They have ranged from updating Suspected Unapproved Parts case files to independently interviewing NASA employees to turn up general background information. The 01 has the duty of informing NASA aeronautical safety managers of potential Nonconforming products. My mission is to compile a database of Nonconformance reports for distribution. The background information that I turn up from my interviews is then used to determine NASA s susceptibility to acceptance of unapproved parts. The IG organization is divided up into two separate disciplines, the Office of 01 investigations primarily focus on violations of Federal laws. Some of these violations

Fixing past mistakes. Answers to questions about reviews, refunds, disclosures.

PubMed

Fitzgerald, T Jeffrey

2003-10-01

A medical group must address practical and legal issues when it discovers improper payments, billing mistakes or alleged misconduct. Its response has a significant impact on how the charges are resolved. A group and its providers can come under fraud and abuse investigations, whistle-blower allegations and Medicare payment reviews. Many questions arise in response to billing errors or allegations of misconduct.

Distance Education: Improved Data on Program Costs and Guidelines on Quality Assessments Needed To Inform Federal Policy. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Ashby, Cornelia M.

Distance education--that is, offering courses by Internet, video, or other forms outside the classroom--has changed considerably in recent years and is a growing force in postsecondary education. More than a decade ago, concerns about fraud and abuse by some correspondence schools led to federal restrictions on, among other things, the percentage…

TRICARE; TRICARE sanction authority for third-party billing agents. Final rule.

PubMed

2013-02-26

This final rule will provide the Director, TRICARE Management Activity (TMA), or designee, with the authority to sanction third-party billing agents by invoking the administrative remedy of exclusion or suspension from the TRICARE program. Such sanctions may be invoked in situations involving fraud or abuse on the part of third-party billing agents that prepare or submit claims presented to TRICARE for payment.

Prevalence of Financial Fraud and Scams Among Older Adults in the United States: A Systematic Review and Meta-Analysis.

PubMed

Burnes, David; Henderson, Charles R; Sheppard, Christine; Zhao, Rebecca; Pillemer, Karl; Lachs, Mark S

2017-08-01

The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers. A valid estimate of elder financial fraud-scam prevalence is necessary as a foundation for research and prevention efforts. To estimate the prevalence of elder financial fraud-scam victimization in the United States based on a systematic review and meta-analysis. Multiple investigators independently screened titles and abstracts and reviewed relevant full-text records from PubMed, Medline, PsycINFO, Criminal Justice Abstracts, Social Work Abstracts, and AgeLine databases. To maximize the validity and generalizability of prevalence estimation, we restricted eligibility to general population-based studies (English speaking, 1990 onward) using state- or national-level probability sampling and collecting data directly from older adults. Information on elder financial fraud-scam prevalence and study-level characteristics was extracted independently by 2 investigators. Meta-analysis of elder financial fraud-scam prevalence used generalized mixed models with individual studies as levels of a random classification factor. We included 12 studies involving a total of 41 711 individuals in the meta-analysis. Overall pooled elder financial fraud-scam prevalence (up to 5-year period) across studies was 5.6% (95% confidence interval [CI] = 4.0%, 7.8%), with a 1-year period prevalence of 5.4% (95% CI = 3.2%, 7.6%). Studies using a series of questions describing specific fraud-scam events to measure victimization found a significantly higher prevalence (7.1%; 95% CI = 4.8%, 9.4%) than studies using a single, general-question self-report assessment approach (3.6%; 95% CI = 1.8%, 5.4%). Elder financial fraud and scams is a common problem, affecting approximately 1 of every 18 cognitively intact, community-dwelling older adults each year; it requires further attention from researchers, clinicians, and policymakers. Elder financial fraud-scam prevalence findings in this study likely underestimate the true population prevalence. We provide methodological recommendations to limit older adult participation and reporting bias in future population-based research. Public Health Implications. Elder financial exploitation victimization is associated with mortality, hospitalization, and poor physical and mental health. Health care professionals working with older adults likely routinely encounter patients who are fraud-scam victims. Validation of instruments to screen for elder financial fraud and scams in clinical settings is an important area of future research. Without effective primary prevention strategies, the absolute scope of this problem will escalate with the growing population of older adults.

Using the OIG model compliance programs to fight fraud.

PubMed

Lovitky, Jeffrey A; Ahern, Jack

2002-03-01

Many healthcare organizations already have implemented compliance programs for their facilities. However, in light of recent fines and continued scrutiny of such programs by the HHS Office of Inspector General (OIG), healthcare organizations should consider reviewing their current programs against the OIG's relevant model compliance program. Although healthcare organizations are not required to adhere strictly to OIG's model programs, they would benefit from ensuring that their programs meet all the OIG's requirements. The common, minimum elements suggested by the OIG model programs include development and distribution of written compliance policies, the designation of a chief compliance officer to manage the program, the development of a corrective action and enforcement system, and the use of audits to monitor compliance. Using these models as guides, healthcare organizations should be better able to avoid the possibility of fraud and abuse within their organizations.

Combating healthcare corruption and fraud with improved global health governance

PubMed Central

2012-01-01

Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of “global health corruption” and development of a treaty protocol to combat this crucial issue. PMID:23088820

The Adoption of Electronic Benefit Transfer Card for Delivering Food Stamp Benefits in Alabama: Perceptions of College Students Participating in the Food Stamp Program

ERIC Educational Resources Information Center

Zekeri, Andrew A.

2004-01-01

The reasons for moving from paper coupons to delivering food stamps electronically include potential reduction in the cost of administering the system and in fraud, theft and abuse of the system. Furthermore, the use of EBT is believed o reduce social stigma and embarrassment felt by recipients when using paper coupon. Therefore, using survey data…

Distance Education: Improved Data on Program Costs and Guidelines on Quality Assessments Needed To Inform Federal Policy. Report to Congressional Requesters. GAO-04-279

ERIC Educational Resources Information Center

US General Accounting Office, 2004

2004-01-01

Over a decade ago, concerns about fraud and abuse by some correspondence schools led to federal restrictions on, among other things, the percentage of courses a school could provide by distance education and still qualify for federal student aid. This study reviewed the extent to which the restrictions affected schools? ability to offer federal…

Child Care and Development Fund: Undercover Tests Show Five State Programs Are Vulnerable to Fraud and Abuse. Report to Congressional Addressees. GAO-10-1062

ERIC Educational Resources Information Center

Kutz, Gregory D.

2010-01-01

Through the Child Care and Development Fund (CCDF), the U.S. Department of Health and Human Services (HHS) subsidizes child care for low-income families whose parents work or attend education or training programs. In fiscal year 2009, the CCDF budget was $7 billion. States are responsible for determining program priorities and overseeing funds.…

42 CFR 455.470 - Temporary moratoria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... imposition of temporary moratoria on enrollment of new providers or provider types prior to imposition of the... moratoria on enrollment of new providers or provider types identified by the Secretary as posing an... limits that the State Medicaid agency identifies as having a significant potential for fraud, waste, or...

32 CFR 700.332 - The Naval Inspector General.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Serving as the Department of the Navy coordinator for fraud, waste and efficiency matters; (6) Serving as....332 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy...

32 CFR 700.332 - The Naval Inspector General.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Serving as the Department of the Navy coordinator for fraud, waste and efficiency matters; (6) Serving as....332 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy...

32 CFR 700.332 - The Naval Inspector General.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Serving as the Department of the Navy coordinator for fraud, waste and efficiency matters; (6) Serving as....332 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy...

32 CFR 700.332 - The Naval Inspector General.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Serving as the Department of the Navy coordinator for fraud, waste and efficiency matters; (6) Serving as....332 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy...

32 CFR 700.332 - The Naval Inspector General.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Serving as the Department of the Navy coordinator for fraud, waste and efficiency matters; (6) Serving as....332 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy...

77 FR 74185 - Notice of Debarment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... from the schools and libraries universal service support mechanism (or ``E-Rate Program'') for a period of three years. The Bureau takes this action to protect the E-Rate Program from waste, fraud and... and libraries universal service support mechanism (E-Rate program) for three years from either the...

Stark laws and fair market value exceptions: an introduction.

PubMed

Siebrasse, Paul B

2007-01-01

This article will focus on one aspect of complexity in modern healthcare, namely the implications of Stark laws and other fraud and abuse provisions, including anti-kickback statutes and HIPAA. Also, this article explores the prevalence of fair market value as an exception in the Stark laws and discusses the meanings of those exceptions. Finally, the article explores basic approaches to assessing fair market value, including cost, income, and marketing approaches.

Head Start: Undercover Testing Finds Fraud and Abuse at Selected Head Start Centers. Testimony before the Committee on Education and Labor, House of Representatives. GAO-10-733T

ERIC Educational Resources Information Center

Kutz, Gregory D.

2010-01-01

The Head Start program, overseen by the Department of Health and Human Services and administered by the Office of Head Start, provides child development services primarily to low-income families and their children. Federal law allows up to 10 percent of enrolled families to have incomes above 130 percent of the poverty line--GAO (Government…

77 FR 13388 - Treasury Inspector General for Tax Administration; Privacy Act of 1974: Computer Matching Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

...: Computer Matching Program AGENCY: Treasury Inspector General for Tax Administration, Treasury. ACTION... Internal Revenue Service (IRS) concerning the conduct of TIGTA's computer matching program. DATES... INFORMATION: TIGTA's computer matching program assists in the detection and deterrence of fraud, waste, and...

3 CFR 13520 - Executive Order 13520 of November 20, 2009. Reducing Improper Payments

Code of Federal Regulations, 2010 CFR

2010-01-01

... General and the Director of OMB, shall publish on the Internet information about improper payments under... Internet-based method to collect from the public information concerning suspected incidents of waste, fraud... Federal Government. (d) Agencies shall place a prominently displayed link to Internet-based resources for...

A decision support tool for identifying abuse of controlled substances by ForwardHealth Medicaid members.

PubMed

Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal

2010-01-01

Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has enabled development and application of a decision tree for detecting recipient fraud and abuse of controlled substance medications. Using standard pharmacy claims data, the decision tree effectively replicates pharmacist manual review recommendations. The DST has automated extraction and evaluation of pharmacy claims data for creating recommendations for guiding pharmacists in the selection of profiles for manual review. The DST is now the primary method used by the Wisconsin Medicaid program to detect fraud and abuse of physician and pharmacy services committed by recipients.

DRG benchmarking study establishes national coding norms.

PubMed

Vaul, J H

1998-05-01

With the increase in fraud and abuse investigations, healthcare financial managers should examine their organization's medical record coding procedures. The Federal government and third-party payers are looking specifically for improper billing of outpatient services, unbundling of procedures to increase payment, assigning higher-paying DRG codes for inpatient claims, and other abuses. A recent benchmarking study of Medicare Provider Analysis and Review (MEDPAR) data has established national norms for hospital coding and case mix based on DRGs and has revealed the majority of atypical coding cases fall into six DRG pairs. Organizations with a greater percentage of atypical cases--those more likely to be scrutinized by Federal investigators--will want to conduct suitable review and be sure appropriate documentation exists to justify the coding.

The Different Faces of Impulsivity as Links between Childhood Maltreatment and Young Adult Crime

PubMed Central

Shin, Sunny H.; Cook, Amy K.; Morris, Nancy A.; McDougle, Robyn; Groves, Lauren Peasley

2016-01-01

Crime is a major public health and safety threat. Many studies have suggested that early exposure to child maltreatment increases an individual's risk for persistent serious crime in adulthood. Despite these findings about the connection between child maltreatment and criminal behavior, there is a paucity of empirically-based knowledge about the processes or pathways that link child maltreatment to later involvement in crime. Using a community sample of 337 young adults (ages 18-25) in a U.S. metropolitan area, the present study examined the role of various facets of impulsivity in linking child maltreatment to crime. A series of factor analyses identified three types of crime including property crime, violent crime, and fraud. Structural equation modelings were conducted to examine the associations among childhood maltreatment, four facets of impulsivity, and criminal behavior, controlling for sociodemographic information, family income and psychological symptoms. The present study found that child emotional abuse was indirectly related to property crime and fraud through urgency while a lack of premeditation mediates the relationship between child neglect and property crime. Child physical abuse was directly related to all three types of crime. Personality traits of urgency and lack of premeditation may play a significant role in the maltreatment-crime link. Preventive interventions targeting impulsivity traits such as urgency and a lack of premeditation might have promising impacts in curbing criminal behavior among maltreatment victims. PMID:27083525

Guidelines for conducting vulnerability assessments. [Susceptibility of programs to unauthorized use of resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1982-06-01

The US General Accounting Office and executive agency Inspectors General have reported losses of millions of dollars in government funds resulting from fraud, waste and error. The Administration and the Congress have initiated determined efforts to eliminate such losses from government programs and activities. Primary emphasis in this effort is on the strengthening of accounting and administrative controls. Accordingly, the Office of Management and Budget (OMB) issued Circular No. A-123, Internal Control Systems, on October 28, 1981. The campaign to improve internal controls was endorsed by the Secretary of Energy in a memorandum to Heads of Departmental Components, dated Marchmore » 13, 1981, Subject: Internal Control as a Deterrent to Fraud, Waste and Error. A vulnerability assessment is a review of the susceptibility of a program or function to unauthorized use of resources, errors in reports and information, and illegal or unethical acts. It is based on considerations of the environment in which the program or function is carried out, the inherent riskiness of the program or function, and a preliminary evaluation as to whether adequate safeguards exist and are functioning.« less

Practitioner-provider joint ventures, the OIG, and the IRS.

PubMed

MacKelvie, C F; Handler, M S; Sanborn, A B

1992-11-01

Increased forays by hospitals and physicians into joint ventures make both parties subject to a complex network of laws and regulations and to scrutiny by many Federal agencies. Institutional healthcare providers should be aware of the legal pitfalls and exercise extreme caution when creating such arrangements. This is the second of a two-part examination of issues relative to taxes and Medicare and Medicaid fraud and abuse regulations. (Part I was published in the October 1992 issue of HFM.)

Crisis management can leave residual effects.

PubMed

Margolis, G L; DeMuro, P R

1991-10-01

A healthcare organization that once suffered from poor financial performance may fail to correct recovery methods that can cause lingering legal and accounting problems. A crisis management style is prone to creating problems with an organization's debt structure, Medicare and Medicaid payment, tax issues, labor relations, licensing and accreditation, compliance with fraud and abuse rules, and accounting for charity care. After stabilizing a worrisome financial situation, a healthcare organization should conduct an internal audit to ensure that its legal and accounting practices remain above board.

Ethics in exercise science research.

PubMed

Shephard, Roy J

2002-01-01

Ethical evaluation is a vital but sometimes neglected component of research policy in the exercise sciences. This article reviews some issues in human research, with particular reference to studies undertaken by the exercise scientist. The typical composition and functions of the research review committee are examined in the context of individual and institutional ethical norms. In multicentre trials, there are often problems in coordinating ethical approval between institutions. On-going monitoring of research may have value in the detection of fraud. A reduction in the secrecy of committee proceedings would allow a closer auditing of the research review process. Authors need to give more thought to developing appropriate research questions. Scarce resources may be wasted because of inappropriate study design or an inadequate statistical analysis of the results. The costs of any proposed investigation must be weighed carefully against possible benefits. Confidentiality is particularly important when collecting data at the worksite or over the internet. Informed consent should be based on a full disclosure of risks; the participant should be competent to understand the nature and magnitude of these risks, and undue pressure to participate in an experiment must be avoided. The opposition to placebo trials expressed in the Declaration of Helsinki requires careful consideration of the use of control groups, since regular exercise is known to benefit health. If research is conducted in under-developed societies, the standards of treatment of the participants should match those expected in developed societies. The publication of findings must be fair and well balanced; examples of fraud and misconduct continue to be reported. Some journals apparently still publish papers, even if they have not received an initial institutional review. Editors should restore meaning to the word 'author', avoid the bias to a publication of 'positive' results, limit the impact of commercial sponsorship on reporting and curtail the current trend to redundant presentations and publications. Development of academic courses in research ethics may help to avoid some of these abuses.

Elder abuse awareness in Italy: analysis of reports to the Prosecutor Office of Bologna.

PubMed

Salsi, Giancarlo; Mazzotti, Maria Carla; Carosielli, Grazia; Ingravallo, Francesca; Pelotti, Susi

2015-06-01

In Italy, the prevalence of elder abuse is estimated from 10 to 12.7 %. Even if the elderly are not specifically protected by the Italian Penal Code, it contains several articles punishing crimes against disadvantaged groups in which elders may be included. Article 572 about mistreatment of family members or cohabitants, and article 643 about circumvention of incapable best fit elder abuse or neglect and financial fraud and exploitation, respectively. To evaluate the prevalence of reported elder abuse in Bologna and province (Italy) compared to available data on prevalence obtained by population-based surveys. Reports to the Prosecutor Office about articles 572 and 643 in the period from 2000 to 2013 were collected and analyzed according to victim's age at the report time. For article 572 a total of 3,713 reports were found. The prevalence of reports ranged from 0.005 to 0.024 % for victims older than 65 years. Concerning article 643 a total of 786 reports were detected, with a prevalence ranging from 0.007 to 0.016 % for victims older than 65 years. A large gap was found between reported crimes related to elder abuse and the estimated prevalence of elder abuse in Italy. Our results showed that in Italy efforts to improve strategic approach on elder abuse as well as research at various levels following the examples of other abusive situations are needed in both health and legal systems.

Special report on taxation. IRS issues stricter guidelines for audits of tax-exempt hospitals.

PubMed

Solomon, J E

1992-07-01

The new audit guidelines serve as yet another reminder to tax-exempt hospitals that great care must be taken in structuring and documenting business arrangements with physicians and executives so as to withstand scrutiny by the IRS with regard to exempt status. Since increased census and utilization, and enhancement of the hospital's financial position, are no longer acceptable justifications for such activities as physician recruitment incentives (being suggestive of payment for referrals), it is important that hospitals make an effort to ensure that board minutes, recruitment policies, internal memoranda, and other documentation set forth the reasons--other than the benefits to the institution's bottom line--for having entered into such transactions. Hospitals must establish and document a community need for each physician recruited. Hospitals that actively recruit should be armed with studies evaluating recruiting needs in each clinical area, based on objective criteria, taking into consideration managed care contracting needs and the provision of services to the poor and needy. Finally, hospitals should re-examine all joint ventures and other business relationships with physicians to determine whether such arrangements resulted from arm's length negotiation, involve fair market value for goods and services, and conform, insofar as possible, with the Medicare fraud and abuse safe harbor regulations. Under GCM 39862 and the new guidelines, "aggressive" arrangements may not only create exposure under fraud and abuse laws, but could jeopardize the provider's tax-exempt status as well.

The different faces of impulsivity as links between childhood maltreatment and young adult crime.

PubMed

Shin, Sunny H; Cook, Amy K; Morris, Nancy A; McDougle, Robyn; Groves, Lauren Peasley

2016-07-01

Crime is a major public health and safety threat. Many studies have suggested that early exposure to child maltreatment increases an individual's risk for persistent serious crime in adulthood. Despite these findings about the connection between child maltreatment and criminal behavior, there is a paucity of empirically-based knowledge about the processes or pathways that link child maltreatment to later involvement in crime. Using a community sample of 337 young adults (ages 18-25) in a U.S. metropolitan area, the present study examined the role of various facets of impulsivity in linking child maltreatment to crime. A series of factor analyses identified three types of crime including property crime, violent crime, and fraud. Structural equation modelings were conducted to examine the associations among childhood maltreatment, four facets of impulsivity, and criminal behavior, controlling for sociodemographic information, family income and psychological symptoms. The present study found that child emotional abuse was indirectly related to property crime and fraud through urgency while a lack of premeditation mediates the relationship between child neglect and property crime. Child physical abuse was directly related to all three types of crime. Personality traits of urgency and lack of premeditation may play a significant role in the maltreatment-crime link. Preventive interventions targeting impulsivity traits such as urgency and a lack of premeditation might have promising impacts in curbing criminal behavior among maltreatment victims. Copyright © 2016 Elsevier Inc. All rights reserved.

Pharmacy Benefit Management Companies: Do They Create Value in the US Healthcare System?

PubMed

Lyles, Alan

2017-05-01

Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing. Whether these potential outcomes are realized within the relevant budget is a function of the healthcare system and the interaction of benefit design and clinical processes-not just individually vetted components. Efficiencies and values achieved in price discounts and cost sharing can be nullified if there is irrational prescribing (over-utilization, under-utilization and mis-utilization), variable patient adherence to medication regimens, ineffective formulary processes, or fraud, waste and abuse. Rising prescription drug costs and the increasing prevalence of 'high deductible health plans', which require much greater patient out-of-pocket costs, is creating a crisis for PBM efforts towards an affordable pharmacy benefit. Since PBM rebate and incentive contracts are opaque to the public, whether they add value by restraining higher drug prices or benefit from them is debatable.

Practice Benchmarking in the Age of Targeted Auditing

PubMed Central

Langdale, Ryan P.; Holland, Ben F.

2012-01-01

The frequency and sophistication of health care reimbursement auditing has progressed rapidly in recent years, leaving many oncologists wondering whether their private practices would survive a full-scale Office of the Inspector General (OIG) investigation. The Medicare Part B claims database provides a rich source of information for physicians seeking to understand how their billing practices measure up to their peers, both locally and nationally. This database was dissected by a team of cancer specialists to uncover important benchmarks related to targeted auditing. All critical Medicare charges, payments, denials, and service ratios in this article were derived from the full 2010 Medicare Part B claims database. Relevant claims were limited by using Medicare provider specialty codes 83 (hematology/oncology) and 90 (medical oncology), with an emphasis on claims filed from the physician office place of service (11). All charges, denials, and payments were summarized at the Current Procedural Terminology code level to drive practice benchmarking standards. A careful analysis of this data set, combined with the published audit priorities of the OIG, produced germane benchmarks from which medical oncologists can monitor, measure and improve on common areas of billing fraud, waste or abuse in their practices. Part II of this series and analysis will focus on information pertinent to radiation oncologists. PMID:23598847

Resilience Analytics with Application to Power Grid of a Developing Region.

PubMed

Thorisson, Heimir; Lambert, James H; Cardenas, John J; Linkov, Igor

2017-07-01

Infrastructure development of volatile regions is a significant investment by international government and nongovernment organizations, with attendant requirements for risk management. Global development banks may be tasked to manage these investments and provide a channel between donors and borrowers. Moreover, various stakeholders from the private sector, local and international agencies, and the military can be engaged in conception, planning, and implementation of constituent projects. Emergent and future conditions of military conflict, politics, economics, technology, environment, behaviors, institutions, and society that stress infrastructure development are prevalent, and funding mechanisms are vulnerable to fraud, waste, and abuse. This article will apply resilience analytics with scenario-based preferences to identify the stressors that most influence a prioritization of initiatives in the electric power sector of Afghanistan. The resilience in this article is conceived in terms of the degree of disruption of priorities when stressors influence the preferences of stakeholders, and ultimately a prioritization of initiatives. The ancillary results include an understanding of which initiatives contribute most and least across strategic criteria and which criteria have the most impact for the analysis. The article concludes with recommendations for risk monitoring and risk management of the portfolio of stressors through the life cycle and horizon of grid capacity expansion. © 2016 Society for Risk Analysis.

Practice benchmarking in the age of targeted auditing.

PubMed

Langdale, Ryan P; Holland, Ben F

2012-11-01

The frequency and sophistication of health care reimbursement auditing has progressed rapidly in recent years, leaving many oncologists wondering whether their private practices would survive a full-scale Office of the Inspector General (OIG) investigation. The Medicare Part B claims database provides a rich source of information for physicians seeking to understand how their billing practices measure up to their peers, both locally and nationally. This database was dissected by a team of cancer specialists to uncover important benchmarks related to targeted auditing. All critical Medicare charges, payments, denials, and service ratios in this article were derived from the full 2010 Medicare Part B claims database. Relevant claims were limited by using Medicare provider specialty codes 83 (hematology/oncology) and 90 (medical oncology), with an emphasis on claims filed from the physician office place of service (11). All charges, denials, and payments were summarized at the Current Procedural Terminology code level to drive practice benchmarking standards. A careful analysis of this data set, combined with the published audit priorities of the OIG, produced germane benchmarks from which medical oncologists can monitor, measure and improve on common areas of billing fraud, waste or abuse in their practices. Part II of this series and analysis will focus on information pertinent to radiation oncologists.

[Fraud in medicine with the child as victim. Munchausen syndrome by proxy. A review of the literature].

PubMed

Koopman, H M; Feenstra, J

1988-08-01

In a review of the literature on the subject 'Münchhausen syndrome by proxy' the authors try to give an impression of the history of diagnosis and treatment of this special kind of child abuse. Particularly aspects of confrontation are discussed. They consider features of the chief actors in this very dramatic play. The authors point to problems in differential diagnosis in the framework of other subjects like 'non-accidental poisoning', 'doctor-shopping' and 'filicide'. They discuss ethical and legal consequences.

Health care fraud and abuse data collection program: technical revisions to Healthcare Integrity and Protection Data Bank data collection activities. Final rule.

PubMed

2004-09-21

The rule finalizes technical changes to the Healthcare Integrity and Protection Data Bank (HIPDB) data collection reporting requirements by clarifying the types of personal numeric identifiers that may be reported to the data bank in connection with adverse actions. The rule clarifies that in lieu of a Social Security Number (SSN), an individual taxpayer identification number (ITIN) may be reported to the data bank when, in those limited situations, an individual does not have an SSN.

Structure and practices of the video relay service program; telecommunications relay services and speech-to-speech services for individuals with hearing and speech disabilities. Final rule.

PubMed

2013-07-05

In this document, the Commission adopts further measures to improve the structure, efficiency, and quality of the video relay service (VRS) program, reducing the inefficiencies in the program, as well as reducing the risk of waste, fraud, and abuse, and ensuring that the program makes full use of advances in commercially-available technology. These measures involve a fundamental restructuring of the program to support innovation and competition, drive down ratepayer and provider costs, eliminate incentives for waste that have burdened the Telecommunications Relay Services (TRS) Fund in the past, and further protect consumers. The Commission adopts several measures in order to: ensure that VRS users can easily select their provider of choice by promoting the development of interoperability and portability standards; enable consumers to use off-the-shelf devices and deploying a VRS application to work with these devices; create a centralized TRS User Registration Database to ensure VRS user eligibility; encourage competition and innovation in VRS call handling services; spur research and development on VRS services by entering into a Memorandum of Understanding with the National Science Foundation; and pilot a National Outreach Program to educate the general public about relay services. In this document, the Commission also adopts new VRS compensation rates that move these rates toward actual costs over the next four years which will better approximate the actual, reasonable costs of providing VRS, and will reduce the costs of operating the program. The Commission takes these steps to ensure the integrity of the TRS Fund while providing stability and certainty to providers.

Elder abuse in Europe's "most elderly" city: an assessment of the phenomenon and an analysis of the data from the Penal Court of Genoa from 2010 to 2015.

PubMed

Molinelli, Andrea; Ventura, Francesco; Pinto, Sara Lo; Drommi, Martina; De Stefano, Francesco

2017-12-01

In Italy, 5% of the elderly are estimated to have suffered abuse. While the Penal Code refers to generic types of abuse, such as physical and psychological maltreatment, abandonment and financial fraud, it does not specifically protect the elderly as a category. To assess the frequency and modalities of elder abuse in Genoa and its Province, and to compare these data with those reported in the literature, in order to provide a picture of the current situation that can be used by the authorities to combat this phenomenon. We analysed the first-degree verdicts issued by the Court of Genoa regarding accusations of physical, psychological and moral abuse and maltreatment of elderly subjects (over 65 years) in the period 2010-2015. Only 85 of the 4028 court verdicts analysed involved elderly persons: 19 cases of domestic maltreatment, 3 of abuse of the means of correction or discipline, 18 of personal injury, 5 of abandonment and 40 of circumvention (deceiving someone, especially an elderly or mentally impaired person, to obtain a profit). A gap was observed between the number of crimes reported to the judicial authorities (tip of the iceberg) and the estimated prevalence of the phenomenon in the literature. There is a need both to create a network of protection for the elderly involving medical and judicial specialists and to train healthcare professionals to better recognise and report cases of maltreatment.

Evaluating motives: Two simple tests to identify and avoid entanglement in legally dubious urine drug testing schemes.

PubMed

Barnes, Michael C; Worthy, Stacey L

2015-01-01

This article educates healthcare practitioners on the legal framework prohibiting abusive practices in urine drug testing (UDT) in medical settings, discusses several profit-driven UDT schemes that have resulted in enforcement actions, and provides recommendations for best practices in UDT to comply with state and federal fraud and anti-kickback statutes. The authors carefully reviewed and analyzed statutes, regulations, adivsory opinions, case law, court documents, articles from legal journals, and news articles. Certain facts-driven UDT arrangements tend to violate federal and state healthcare laws and regulations, including Stark law, the anti-kickback statute, the criminal health care fraud statute, and the False Claims Act. Healthcare practitioners who use UDT can help ensure that they are in compliance with applicable federal and state laws by evaluating whether their actions are motivated by providing proper care to their patients rather than by profits. They must avoid schemes that violate the spirit of the law while appearing to comply with the letter of the law. Such a simple self-evaluation of motive can reduce a practitioner's likelihood of civil fines and criminal liability.

Is tattooing a risk factor for adolescents' criminal behavior? Empirical evidence from an administrative data set of juvenile detainees in Taiwan.

PubMed

Liao, Pei-An; Chang, Hung-Hao; Su, Yi-Ju

2014-12-01

Juvenile crime affects not only the victims of the crime but also the delinquents' future. How to prevent adolescent criminal behavior has become an important public policy issue. This study contributes to this interesting issue by examining the relationship between tattooing and adolescents' criminal behavior. In particular, this study investigates whether or not having a tattoo/tattoos is connected to the incidence of various criminal activities, including: larceny, robbery, fraud, assault, drug use, and homicide. A unique sample of 973 juvenile detainees drawn from the administrative profiles in Taiwan and the coarsened exact matching method were utilized. Results show that compared to their nontattooed counterparts, tattooed juvenile detainees were significantly more likely to commit fraud, assault, drug abuse, and homicide by 3%, 13%, 9%, and 9%, respectively. In contrast, tattooing was not significantly associated with larceny or robbery. From a policy perspective, given the significant link between tattooing and criminal behavior, the presence of a tattoo in adolescents may serve as a valuable indicator regarding adolescents' high probability of committing crimes. © 2014 Society for Risk Analysis.

[Social and legal problems in the so-called poriomania, with special reference to desertion and AWOL].

PubMed

Dieckhöfer, K; Vogel, T

1974-01-01

Following a synopsis of the main bibliography and a number of own cases it could be pointed out that the so-called poriomania is accompanied with punishable acts in about one-third of all cases. An analysis of the different delicts yielded as result a clear preponderance of larcency of money, fraud and embezzlement - in comparison with desertion and absence without official leave. Only 20% of all cases with punishable acts were denounced. In former times, up to the first world war, about a percentage of 74 of all criminal cases in connection with poriomania was exonerated on the erroneous assumption that the behaviour of the so-called poriomania would be caused by epilepsy. About one third of all persons with poriomania are feebleminded. There is a high inclination to fraud, pseudologia, abuse of alcohol and prostitution. An enlarged inclination (15%) to suicide is also remarkable. A familiar accumulation of poriomania does not justify the supposition of an endogenous factor. Therefore criminal acts in connection with poriomania connot be exonerated. The personality of men with poriomania is characterised by unsteadiness, unstableness and velleity.

Health care fraud and abuse data collection program: technical revisions to healthcare integrity and protection data bank data collection activities. Interim final rule with comment period.

PubMed

2004-06-17

The rule makes technical changes to the Healthcare Integrity and Protection Data Bank (HIPDB) data collection reporting requirements set forth in 45 CFR part 61 by clarifying the types of personal numeric identifiers that may be reported to the data bank in connection with adverse actions. Specifically, the rule clarifies that in lieu of a Social Security Number (SSN), an individual taxpayer identification number (ITIN) may be reported to the data bank when, in those limited situations, an individual does not have an SSN.

Commercial speech and off-label drug uses: what role for wide acceptance, general recognition and research incentives?

PubMed

Gilhooley, Margaret

2011-01-01

This article provides an overview of how the constitutional protections for commercial speech affect the Food and Drug Administration's (FDA) regulation of drugs, and the emerging issues about the scope of these protections. A federal district court has already found that commercial speech allows manufacturers to distribute reprints of medical articles about a new off-label use of a drug as long as it contains disclosures to prevent deception and to inform readers about the lack of FDA review. This paper summarizes the current agency guidance that accepts the manufacturer's distribution of reprints with disclosures. Allergan, the maker of Botox, recently maintained in a lawsuit that the First Amendment permits drug companies to provide "truthful information" to doctors about "widely accepted" off-label uses of a drug. While the case was settled as part of a fraud and abuse case on other grounds, extending constitutional protections generally to "widely accepted" uses is not warranted, especially if it covers the use of a drug for a new purpose that needs more proof of efficacy, and that can involve substantial risks. A health law academic pointed out in an article examining a fraud and abuse case that off-label use of drugs is common, and that practitioners may lack adequate dosage information about the off-label uses. Drug companies may obtain approval of a drug for a narrow use, such as for a specific type of pain, but practitioners use the drug for similar uses based on their experience. The writer maintained that a controlled study may not be necessary to establish efficacy for an expanded use of a drug for pain. Even if this is the case, as discussed below in this paper, added safety risks may exist if the expansion covers a longer period of time and use by a wider number of patients. The protections for commercial speech should not be extended to allow manufacturers to distribute information about practitioner use with a disclosure about the lack of FDA approval. Distributions of information about unapproved uses should not be acceptable unless experts consider the expanded use to be generally recognized as safe and effective based on adequate studies. The last part of this paper considers the need to develop better research incentives to encourage more testing and post-market risk surveillance by drug makers on off-label uses of their drugs. Violations of the Federal Food Drug and Cosmetic Act (FFDCA) can be considered violations of the False Claims Act, which opens the way to fraud and abuse suits. The scale of penalties involved in these suits may lead to more examination of the scope of FDA regulation and commercial speech protections. Thus this symposium's consideration of these issues is timely and important.

Testing the woman abuse screening tool to identify intimate partner violence in Indonesia.

PubMed

Iskandar, Livia; Braun, Kathryn L; Katz, Alan R

2015-04-01

Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance. © The Author(s) 2014.

Knowledge Discovery from Massive Healthcare Claims Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chandola, Varun; Sukumar, Sreenivas R; Schryver, Jack C

The role of big data in addressing the needs of the present healthcare system in US and rest of the world has been echoed by government, private, and academic sectors. There has been a growing emphasis to explore the promise of big data analytics in tapping the potential of the massive healthcare data emanating from private and government health insurance providers. While the domain implications of such collaboration are well known, this type of data has been explored to a limited extent in the data mining community. The objective of this paper is two fold: first, we introduce the emergingmore » domain of big"healthcare claims data to the KDD community, and second, we describe the success and challenges that we encountered in analyzing this data using state of art analytics for massive data. Specically, we translate the problem of analyzing healthcare data into some of the most well-known analysis problems in the data mining community, social network analysis, text mining, and temporal analysis and higher order feature construction, and describe how advances within each of these areas can be leveraged to understand the domain of healthcare. Each case study illustrates a unique intersection of data mining and healthcare with a common objective of improving the cost-care ratio by mining for opportunities to improve healthcare operations and reducing hat seems to fall under fraud, waste,and abuse.« less

Perceptions of Elders' Substance Abuse and Resilience

ERIC Educational Resources Information Center

Kane, Michael N.; Green, Diane

2009-01-01

Human service students' (social work, criminal justice, public administration, psychology) were surveyed (N = 242). Their perceptions about older persons' resilience and recovery from substance abuse were investigated. Overall, respondents did not agree that treating older persons for a substance abuse problem was wasteful of resources or older…

Feathered Detectives: Real-Time GPS Tracking of Scavenging Gulls Pinpoints Illegal Waste Dumping.

PubMed

Navarro, Joan; Grémillet, David; Afán, Isabel; Ramírez, Francisco; Bouten, Willem; Forero, Manuela G

2016-01-01

Urban waste impacts human and environmental health, and waste management has become one of the major challenges of humanity. Concurrently with new directives due to manage this human by-product, illegal dumping has become one of the most lucrative activities of organized crime. Beyond economic fraud, illegal waste disposal strongly enhances uncontrolled dissemination of human pathogens, pollutants and invasive species. Here, we demonstrate the potential of novel real-time GPS tracking of scavenging species to detect environmental crime. Specifically, we were able to detect illegal activities at an officially closed dump, which was visited recurrently by 5 of 19 GPS-tracked yellow-legged gulls (Larus michahellis). In comparison with conventional land-based surveys, GPS tracking allows a much wider and cost-efficient spatiotemporal coverage, even of the most hazardous sites, while GPS data accessibility through the internet enables rapid intervention. Our results suggest that multi-species guilds of feathered detectives equipped with GPS and cameras could help fight illegal dumping at continental scales. We encourage further experimental studies, to infer waste detection thresholds in gulls and other scavenging species exploiting human waste dumps.

Feathered Detectives: Real-Time GPS Tracking of Scavenging Gulls Pinpoints Illegal Waste Dumping

PubMed Central

Grémillet, David; Afán, Isabel; Ramírez, Francisco; Bouten, Willem; Forero, Manuela G.

2016-01-01

Urban waste impacts human and environmental health, and waste management has become one of the major challenges of humanity. Concurrently with new directives due to manage this human by-product, illegal dumping has become one of the most lucrative activities of organized crime. Beyond economic fraud, illegal waste disposal strongly enhances uncontrolled dissemination of human pathogens, pollutants and invasive species. Here, we demonstrate the potential of novel real-time GPS tracking of scavenging species to detect environmental crime. Specifically, we were able to detect illegal activities at an officially closed dump, which was visited recurrently by 5 of 19 GPS-tracked yellow-legged gulls (Larus michahellis). In comparison with conventional land-based surveys, GPS tracking allows a much wider and cost-efficient spatiotemporal coverage, even of the most hazardous sites, while GPS data accessibility through the internet enables rapid intervention. Our results suggest that multi-species guilds of feathered detectives equipped with GPS and cameras could help fight illegal dumping at continental scales. We encourage further experimental studies, to infer waste detection thresholds in gulls and other scavenging species exploiting human waste dumps. PMID:27448048

NATO Phase Zero Contracting - A Proposed Strategic and Operational Planning Construct Within the NATO Framework for Defense Planning and Standardization

DTIC Science & Technology

2015-02-12

become better stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational...stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational redundancy and...Conference—Best Practices and Lessons Learned and Training and Educating for Acquisition, Procurement and Contracting in Defense Institutions

FraudBuster: Reducing Fraud in an Auto Insurance Market.

PubMed

Nagrecha, Saurabh; Johnson, Reid A; Chawla, Nitesh V

2018-03-01

Nonstandard insurers suffer from a peculiar variant of fraud wherein an overwhelming majority of claims have the semblance of fraud. We show that state-of-the-art fraud detection performs poorly when deployed at underwriting. Our proposed framework "FraudBuster" represents a new paradigm in predicting segments of fraud at underwriting in an interpretable and regulation compliant manner. We show that the most actionable and generalizable profile of fraud is represented by market segments with high confidence of fraud and high loss ratio. We show how these segments can be reported in terms of their constituent policy traits, expected loss ratios, support, and confidence of fraud. Overall, our predictive models successfully identify fraud with an area under the precision-recall curve of 0.63 and an f-1 score of 0.769.

Medicare and state health care programs: fraud and abuse; safe harbor for federally qualified health centers arrangements under the anti-kickback statute. Final rule.

PubMed

2007-10-04

In accordance with section 431 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), this final rule sets forth a safe harbor under the anti-kickback statute to protect certain arrangements involving goods, items, services, donations, and loans provided by individuals and entities to certain health centers funded under section 330 of the Public Health Service Act. The goods, items, services, donations, or loans must contribute to the health center's ability to maintain or increase the availability, or enhance the quality, of services available to a medically underserved population.

Family medical leave--management strategies.

PubMed

Morris, Judy A; Strasser, Patricia B

2004-12-01

Employers are recognizing the impact of lost productivity on total benefit costs. In a recent report based on 2002 benefit data, lost productivity represented 71% of the full cost of health/absence benefits (Integrated Benefits Institute, 2004). Occupational health nurse managers can develop FMLA leave management policies and programs to assure that leave is provided when appropriate, to help curb FMLA abuse and fraud, and to assist employers in defending adverse employment actions based on attendance. A review of employer policies and FMLA implementation also assesses compliance with the Act and provides the basis for appropriate responses in the case of legal actions and employee complaints to the U.S. Department of Labor.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

PubMed

Khan, Mohammad Nuruzzaman; Rothwell, David W; Cherney, Katrina; Sussman, Tamara

2017-01-01

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

The company man: a case of white-collar crime.

PubMed

Brottman, Mikita

2009-06-01

Insider trading scandals on Wall Street have focused public attention on the abuse of money and power in the service of greed. The analytic situation described in this paper involves a patient who was involved in a major white-collar crime in the 1990s and imprisoned on charges of fraud. Release from prison brought his anxieties about money, work, and masculinity into sharp focus. The paper explores the some of the emotional conflicts and confusion around corporate success and failure, and the particular issues that arise when people identify themselves with the company they work for, something that corporate culture has always encouraged.

Content recognition for telephone monitoring

NASA Astrophysics Data System (ADS)

Wenndt, Stanley J.; Harris, David M.; Cupples, Edward J.

2001-02-01

This research began due to federal inmates abusing their telephone privileges by committing serious offenses such as murder, drug dealing, and fraud. On average, about 1000 calls are made per day at each federal prison with a peak of over 4000. Current monitoring capabilities are very man- intensive and only allow for about 2-3% monitoring of inmate telephone conversations. One of the main deficiencies identified by prison officials is the need to flag phone conversations pertaining to criminal activity. This research looks at two unique voice-processing methods to detect phone conversion pertaining to criminal activity. These two methods are digit string detection and whisper detection.

A case control study: White-collar defendants compared with defendants charged with other nonviolent theft.

PubMed

Poortinga, Ernest; Lemmen, Craig; Jibson, Michael D

2006-01-01

We examined the clinical, criminal, and sociodemographic characteristics of all white-collar crime defendants referred to the evaluation unit of a state center for forensic psychiatry. With 29,310 evaluations in a 12-year period, we found 70 defendants charged with embezzlement, 3 with health care fraud, and no other white-collar defendants (based on the eight crimes widely accepted as white-collar offenses). In a case-control study design, the 70 embezzlement cases were compared with 73 defendants charged with other forms of nonviolent theft. White-collar defendants were found to have a higher likelihood of white race (adjusted odds ratio (adj. OR) = 4.51), more years of education (adj. OR = 3471), and a lower likelihood of substance abuse (adj. OR = .28) than control defendants. Logistic regression modeling showed that the variance in the relationship between unipolar depression and white-collar crime was more economically accounted for by education, race, and substance abuse.

Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: a survey of federal and state laws.

PubMed

Gittler, Josephine

2008-10-01

There are many federal and state laws addressing, directly and indirectly, the quality of care provided to nursing home residents and the protection of residents from mistreatment. They include: (a) state laws that govern the licensing of nursing homes, (b) federal laws that govern the certification of nursing homes for participation in the Medicare and Medicaid programs, (c) elder abuse laws prohibiting mistreatment of older adults in nursing homes and other settings, (d) health care fraud abuse laws that are increasingly being used to combat the provision of substandard care to Medicare and Medicaid beneficiaries in nursing homes, and (e) laws that have established long-term care ombudsman programs to promote the health, safety, well-being, and rights of nursing home residents. While these laws are generally viewed as having improved the care and treatment of nursing home residents, much remains to be done, particularly with respect to the implementation of these laws.

Criminals in the Citadel and Deceit all along the Watchtower: Irresponsibility, Fraud, and Complicity in the Search for Scientific Truth

PubMed Central

Tharyan, Prathap

2012-01-01

Scientific research aims to use reliable methods to produce generalizable new knowledge in order to understand the human condition and maximize human potential. The sanctity accorded to scientific research has been violated by numerous instances of research fraud, as well as deceptive and conflicted research that have seriously harmed people, subverted the evidence-base, wasted valuable resources, and undermined public trust. This deception by individuals has been fostered by the unrealistic expectations of society; facilitated by the complicity of institutions and organisations; and sanctioned by the inaction of supposed gate-keepers. Re-defining misconduct as occurring on a continuum from irresponsible to fraudulent is the first step in confronting this inconvenient truth. Implementing and evaluating multiple strategies targeting systems and individuals that promote the responsible conduct of research, rather than merely exposing serious instances of misconduct by individuals, is urgently required to restore faith in the aspirations, integrity, and results of scientific research. PMID:22654391

Criminals in the Citadel and Deceit all along the Watchtower: Irresponsibility, Fraud, and Complicity in the Search for Scientific Truth.

PubMed

Tharyan, Prathap

2012-01-01

Scientific research aims to use reliable methods to produce generalizable new knowledge in order to understand the human condition and maximize human potential. The sanctity accorded to scientific research has been violated by numerous instances of research fraud, as well as deceptive and conflicted research that have seriously harmed people, subverted the evidence-base, wasted valuable resources, and undermined public trust. This deception by individuals has been fostered by the unrealistic expectations of society; facilitated by the complicity of institutions and organisations; and sanctioned by the inaction of supposed gate-keepers. Re-defining misconduct as occurring on a continuum from irresponsible to fraudulent is the first step in confronting this inconvenient truth. Implementing and evaluating multiple strategies targeting systems and individuals that promote the responsible conduct of research, rather than merely exposing serious instances of misconduct by individuals, is urgently required to restore faith in the aspirations, integrity, and results of scientific research.

Early detection and prevention of domestic violence using the Women Abuse Screening Tool (WAST) in primary health care clinics in Malaysia.

PubMed

Yut-Lin, Wong; Othman, Sajaratulnisah

2008-01-01

Despite being an emergent major public health problem, little research has been done on domestic violence from the perspectives of early detection and prevention. Thus, this cross-sectional study was conducted to identify domestic violence among female adult patients attending health centers at the primary care level and to determine the relationship between social correlates of adult patients and domestic violence screening and subsequent help/health-seeking behavior if abused. Face-to-face interviews were conducted with 710 female adult patients from 8 health centers in Selangor who matched the inclusion criteria and consented to participate in the study, using a structured questionnaire that included adaptation of a validated 8-item Women Abuse Screening Tool (WAST). Statistical tests showed significant differences in ethnicity, income, and education between those screened positive and those screened negative for domestic violence. Of the participants, 92.4% reported that during consultations, doctors had never asked them whether they were abused by their husband/partner. Yet, 67.3% said they would voluntarily tell the doctor if they were abused by their husband/partner. The findings indicate that primary care has an important role in identifying domestic violence by applying the WAST screening tool, or an appropriate adaptation, with women patients during routine visits to the various health centers. Such assessment for abuse could be secondary prevention for the abused women, but more important, it will serve as primary prevention for nonabused women. This approach not only will complement the existing 1-stop crisis center policy by the Ministry of Health that copes with crisis intervention but also will spearhead efforts toward prevention of domestic violence in Malaysia.

Perceptions of per diems in the health sector: evidence and implications

PubMed Central

Vian, Taryn; Miller, Candace; Themba, Zione; Bukuluki, Paul

2013-01-01

Per diems are used to pay work-related expenses and motivate employees, yet they also can distort incentives and may be abused. This study was designed to explore perceptions of per diems among 41 high-, mid- and low-level government officers and non-governmental organization (NGO) officials in Malawi and Uganda. Interviews explored attitudes about per diems, benefits and problems for organizations and individuals, and risks and patterns of abuse. The study found that per diems provide benefits such as encouraging training, increasing staff motivation and supplementing salary. Despite these advantages, respondents voiced many discontents about per diems, stating that they create conflict, contribute to a negative organizational culture where people expect to be paid for all activities, and lead to negative changes in work time allocation. Work practices are also manipulated in order to maximize financial gain by slowing work, scheduling unnecessary trainings, or exaggerating time needed for tasks. Officials may appropriate per diems meant for others or engage in various forms of fraud for personal financial gain. Abuse seemed more common in the government sector due to low pay and weaker controls. A striking finding was the distrust that lower-level workers felt toward their superiors: allowances were perceived to provide unfair financial advantages to already better-off and well-connected staff. To curb abuse of per diems, initiatives must reduce pressures and incentives to abuse, while controlling discretion and increasing transparency in policy implementation. Donors can play a role in reform by supporting development of policy analysis tools, design of control mechanisms and evaluation of reform strategies. PMID:22684639

Perceptions of per diems in the health sector: evidence and implications.

PubMed

Vian, Taryn; Miller, Candace; Themba, Zione; Bukuluki, Paul

2013-05-01

Per diems are used to pay work-related expenses and motivate employees, yet they also can distort incentives and may be abused. This study was designed to explore perceptions of per diems among 41 high-, mid- and low-level government officers and non-governmental organization (NGO) officials in Malawi and Uganda. Interviews explored attitudes about per diems, benefits and problems for organizations and individuals, and risks and patterns of abuse. The study found that per diems provide benefits such as encouraging training, increasing staff motivation and supplementing salary. Despite these advantages, respondents voiced many discontents about per diems, stating that they create conflict, contribute to a negative organizational culture where people expect to be paid for all activities, and lead to negative changes in work time allocation. Work practices are also manipulated in order to maximize financial gain by slowing work, scheduling unnecessary trainings, or exaggerating time needed for tasks. Officials may appropriate per diems meant for others or engage in various forms of fraud for personal financial gain. Abuse seemed more common in the government sector due to low pay and weaker controls. A striking finding was the distrust that lower-level workers felt toward their superiors: allowances were perceived to provide unfair financial advantages to already better-off and well-connected staff. To curb abuse of per diems, initiatives must reduce pressures and incentives to abuse, while controlling discretion and increasing transparency in policy implementation. Donors can play a role in reform by supporting development of policy analysis tools, design of control mechanisms and evaluation of reform strategies.

Internal Controls for the Military Sealift Command Portion of the Transportation Business Area of the FY 1994 Defense Business Operations Fund Financial Statements

DTIC Science & Technology

1995-06-28

Secondary Reports Dilution Unit, Audit Planning and Technical Support Directorate, at (703) 604-8937 (DSN 664-8937) or FAX (703) 604-8932. Suggestions...for Future Audits To suggest ideas for or to request future audits , contact the Planning and Coordination Branch, Audit Planning and Technical...Defense OAIG-AUD (ATTN: APTS Audit Suggestions) 400 Army Navy Drive (Room 801) Arlington, Virginia 22202-2884 DoD Hotline To report fraud, waste

Scientific Misconduct and the Myth of Self-Correction in Science.

PubMed

Stroebe, Wolfgang; Postmes, Tom; Spears, Russell

2012-11-01

The recent Stapel fraud case came as a shattering blow to the scientific community of psychologists and damaged both their image in the media and their collective self-esteem. The field responded with suggestions of how fraud could be prevented. However, the Stapel fraud is only one among many cases. Before basing recommendations on one case, it would be informative to study other cases to assess how these frauds were discovered. The authors analyze a convenience sample of fraud cases to see whether (social) psychology is more susceptible to fraud than other disciplines. They also evaluate whether the peer review process and replications work well in practice to detect fraud. There is no evidence that psychology is more vulnerable to fraud than the biomedical sciences, and most frauds are detected through information from whistleblowers with inside information. On the basis of this analysis, the authors suggest a number of strategies that might reduce the risk of scientific fraud. © The Author(s) 2012.

Who Can You Trust? Protecting Your Organization from Internal Fraud.

ERIC Educational Resources Information Center

Lukaszewski, Thomas E.

1997-01-01

Discusses how to protect a child care organization from employee fraud. Differentiates employee and management fraud and examines reasons fraud is committed. Suggests procedures for protecting an organization from fraud, including establishing an effective internal control system, paying attention to unusual employee behavior, reviewing expense…

Health Care Financing Administration--Medicare and Medicaid programs; protection of patients' funds. Final regulation.

PubMed

1980-07-24

This rule sets forth expanded standards for protection of personal funds of patients in skilled nursing facilities (SNFs) and intermediate care facilities (ICFs) that participate in the Medicare or Medicaid programs. The changes are required for SNFs by Section 21(a) of Pub. L. 95-142, the Medicare-Medcaid Anti-Fraud and Abuse Amendments of 1977, and for ICFs by Section 8(c) of Pub. L. 95-292, the End-Stage Renal Disease Amendments of 1978. The intent is to safeguard patient funds from misuse by facilities, and to assure that personal funds held by the the facilities are fully accounted for and made available to patients when they need or want them.

75 FR 26196 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... Special Fraud Alert on Telemarketing by Durable Medical Equipment Suppliers AGENCY: Office of Inspector... Special Fraud Alert. Specifically, the Updated Special Fraud Alert addressed the statutory provision...) 205-0007. SUPPLEMENTARY INFORMATION: In our publication of the OIG Updated Special Fraud Alert on...

Fighting Domestic and International Fraud in the Admissions and Registrar's Offices

ERIC Educational Resources Information Center

Koenig, Ann M.; Devlin, Edward

2012-01-01

The education sector is no stranger to fraud, unfortunately. This article provides best practice guidance in recognizing and dealing with fraud, with emphasis on domestic and international academic credential fraud. It includes practical approaches to academic document review and verification. Success in fighting fraud requires becoming informed,…

Topical review on the abuse and misuse potential of tramadol and tilidine in Germany.

PubMed

Radbruch, Lukas; Glaeske, Gerd; Grond, Stefan; Münchberg, Frank; Scherbaum, Norbert; Storz, Elisabeth; Tholen, Kathrin; Zagermann-Muncke, Petra; Zieglgänsberger, Walter; Hoffmann-Menzel, Helmut; Greve, Hendrik; Cremer-Schaeffer, Peter

2013-01-01

Tramadol and tilidine (in combination with naloxone) are used as weak opioid analgesics in Germany. Tramadol is not scheduled in the German Narcotic Drugs Act. Tilidine is scheduled, whereas Tilidine in fixed combinations with naloxone is exempt from some of the provisions of the Narcotic Drugs Act. Recent reports on misuse of both substances led to an evaluation of their potential for misuse, abuse, and dependency by the expert advisory committee established by the German Federal Government, resident at the Federal Institute for Drugs and Medical Devices. A subcommittee formulated key questions and identified available data sources for each of these questions. Additional information was solicited where necessary, including a survey among a panel of pharmacists, a survey in an addiction clinic, analysis of prescription patterns, and information from the boards of pharmacists of the federal states and the Federal Bureau of Criminal Investigation. Analgesic efficiency in the treatment of acute and chronic pain has been proven for both tramadol and tilidine/naloxone. For tramadol, high evidence has been confirmed in systematic reviews, and tramadol is listed in national and international guidelines on acute and chronic pain management. Animal and human studies found a low potential for misuse, abuse, and dependency for both substances. Information from 2 tramadol safety databases allowed calculation of the incidence of abuse or dependency as 0.21 and 0.12 cases per million defined daily dosages (DDDs), with lower incidences in recent years. For tilidine/naloxone, the incidence was calculated as 0.43 cases per million DDDs for oral solution and 0.18 for slow-release tablets. In an online survey among German pharmacies as well as in the reports from state pharmacy boards, fraud attempts were repeated more frequently with tilidine/naloxone than with tramadol in the last 2 years. The Federal Bureau of Criminal Investigations reported prescription fraud only with tilidine/naloxone and predominantly in the region of Berlin. Dependency on tramadol or tilidine/naloxone is reported only rarely from addiction counseling centers. One third of the patients surveyed in an addiction clinic reported experiences with tramadol or tilidine/naloxone, but mostly with duration of less than 4 weeks and with a medical prescription based on a reasonable indication. Also, occasional illegal use of opioid analgesics as a substitute of heroin was reported. An evaluation of pooled data from statutory health insurance companies found 2.5% of persons receiving at least 1 prescription of tramadol or the combination of tilidine and naloxone in 2009 (1.6% with tramadol and 1.0% with tilidine/naloxone). High usage with more than 180 DDDs per year was found in 8.6% of patients treated with tramadol and 17.2% of patients with tilidine/naloxone. In conclusion, the subcommittee of the expert advisory committee found a low potential for misuse, abuse, and dependency for tramadol, and a low prevalence in clinical practice. Considerable less information is available for the combination of tilidine and naloxone. However, the cumulation of evidence indicated a higher risk of misuse, abuse, and dependency for tilidine/naloxone solution, but not for slow-release tablets.

7 CFR 276.3 - Negligence or fraud.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Negligence or fraud. 276.3 Section 276.3 Agriculture... Negligence or fraud. (a) General. If FNS determines that there has been negligence or fraud on the part of..., pay to FNS a sum equal to the amount of coupons issued as a result of such negligence or fraud. (b...

Approaches for Establishing Fraud Risk Assessment Programs and Conducting Fraud Audit Risk Assessments Within the Department of Defense

DTIC Science & Technology

2014-07-17

Auditing Health Care Organizations _________ 35 Special Fraud Risk Considerations When Auditing Government Contracts ______________ 36 iv │ DODIG-2014...Auditor Fraud Risk Assessment Special Considerations Special Fraud Risk Considerations When Auditing Health Care Organizations...Learning Opportunities 0 Government Relations (Public Policy and Strategic Relations) Government Relations 0 Health Care Affairs Health Care Affairs 0 Human

Destruction of the recreational, asthetic, agricultural, wildlife conservation and preservation, and residential uses of the land as a result of the abuses of the manufacturing, commercial, extractive, construction, and transportation industries

NASA Technical Reports Server (NTRS)

1975-01-01

Explicit concern over land use and abuse stems from the recognition of the negative impacts of unrestrained and unregulated economic, industrial, and population growth upon finite land resources. Only one quarter of the total surface area of the earth is land, and of that a large portion is uninhabitable. The present stresses upon the land include urbanization, urban sprawl and urban congestion; electrical, nuclear industrial park siting requirements; land degradation through stripping surface minerals; land degradation through disposal of radioactive wastes, sewage sludge, solid waste and other industrial wastes; rising demand for agricultural land; and the erosion and destruction of land through elimination of protective coverings such as forests, grasslands, and wetlands.

Waste and Abuse: Public School Roofing Projects.

ERIC Educational Resources Information Center

2000

This report details the results of a comprehensive inquiry by New Jersey into one aspect of school construction, the repair and replacement of roof systems, which represents the single most expensive and integral component of a school's physical structure. The investigation began in late 1997 after confidential complaints suggested abuse in the…

32 CFR 516.58 - Policies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... LITIGATION Remedies in Procurement Fraud and Corruption § 516.58 Policies. (a) Procurement fraud and... administrative remedies in significant cases of fraud or corruption relating to Army procurement. (d) The key... of fraud or corruption involving procurement. (g) Coordination on the status and disposition of cases...

Contemporary practice in forensic odontology

PubMed Central

Gupta, Shalini; Agnihotri, Archana; Chandra, Akhilesh; Gupta, Om Prakash

2014-01-01

Forensic odontology plays a major role in the identification of those individuals who cannot be identified visually or by other means. The unique nature of dental anatomy and placement of custom restorations ensure accuracy when the techniques are correctly employed. It is evident that identification of victims in accidents and natural calamities is of utmost importance and is a challenging task. The teeth may also be used as weapons and under certain circumstances; they may provide information regarding the identity of the biter. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In this article, we will discuss such evolvement of the subject. PMID:25328306

Medicare and state health care programs: fraud and abuse; electronic health records safe harbor under the anti-kickback statute. Final rule.

PubMed

2013-12-27

In this final rule, the Office of Inspector General (OIG) amends the safe harbor regulation concerning electronic health records items and services, which defines certain conduct that is protected from liability under the Federal anti-kickback statute, section 1128B(b) of the Social Security Act (the Act). Amendments include updating the provision under which electronic health records software is deemed interoperable; removing the electronic prescribing capability requirement; extending the sunset provision until December 31, 2021; limiting the scope of protected donors to exclude laboratory companies; and clarifying the condition that prohibits a donor from taking any action to limit or restrict the use, compatibility, or interoperability of the donated items or services.

78 FR 22270 - Special Fraud Alert: Physician-Owned Entities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

...] Special Fraud Alert: Physician-Owned Entities AGENCY: Office of Inspector General (OIG), HHS. ACTION... Physician-Owned Entities. Specifically, the Special Fraud Alert addressed physician-owned entities that... publication of the Special Fraud Alert on Physician-Owned Entities, an inadvertent error appeared in the DATES...

Introducing Food Fraud including translation and interpretation to Russian, Korean, and Chinese languages.

PubMed

Spink, John; Moyer, Douglas C; Park, Hyeonho; Wu, Yongning; Fersht, Victor; Shao, Bing; Hong, Miao; Paek, Seung Yeop; Edelev, Dmitry

2015-12-15

This paper introduces the topic of Food Fraud with translations to Russian, Korean, and Chinese. The concepts provide a system-wide focus leading to prevention. The goal is not to detect Food Fraud but to adjust entire food supply chains to reduce fraud opportunities. Food Fraud is a recently defined area of Food Protection between Food Safety (such as Salmonella or pesticide residue), and Food Defense (malicious intent to harm such as terrorism). Food Fraud is intentional with no intent to harm but only for economic gain. As with improving Food Safety and Food Defense, preventing Food Fraud is good for society and the economy. Society benefits through fewer public health threats from unauthorized acts. Society also benefits from increased consumer satisfaction and harmony. Food Security is increased through the production of more, higher-value products for consumers, commerce, and exporting. Food Fraud can reduce economic output because sickened citizens cannot work and it also reduces consumer confidence leading to less commerce. Copyright © 2014 Elsevier Ltd. All rights reserved.

Is Psychological Vulnerability Related to the Experience of Fraud in Older Adults?

PubMed Central

LICHTENBERG, PETER A.; STICKNEY, LAURIE; PAULSON, DANIEL

2013-01-01

Financial exploitation, and particularly thefts and scams, are increasing at an alarming rate. In this study we (a) determined the national prevalence of older adults who report having been a victim of fraud, (b) created a population-based model for the prediction of fraud, and (c) examined how fraud is experienced by the most psychologically vulnerable older adults. The older adults studied were 4,400 participants in a Health and Retirement Study substudy, the 2008 Leave Behind Questionnaire. The prevalence of fraud across the previous 5 years was 4.5%. Among measures collected in 2002, age, education, and depression were significant predictors of fraud. Financial satisfaction and social-needs fulfillment were measured in 2008 and were significantly related to fraud above and beyond the 2002 predictors. Using depression and social-needs fulfillment to determine the most psychologically vulnerable older adults, we found that fraud prevalence was three times higher (14%) among those with the highest depression and the lowest social-needs fulfillment than among the rest of the sample (4.1%; χ2 = 20.49; p < .001). Clinical gerontologists and other professionals in the field need to be aware of their psychologically vulnerable clients heightened exposure to financial fraud. PMID:23997404

A Review of Financial Accounting Fraud Detection based on Data Mining Techniques

NASA Astrophysics Data System (ADS)

Sharma, Anuj; Kumar Panigrahi, Prabin

2012-02-01

With an upsurge in financial accounting fraud in the current economic scenario experienced, financial accounting fraud detection (FAFD) has become an emerging topic of great importance for academic, research and industries. The failure of internal auditing system of the organization in identifying the accounting frauds has lead to use of specialized procedures to detect financial accounting fraud, collective known as forensic accounting. Data mining techniques are providing great aid in financial accounting fraud detection, since dealing with the large data volumes and complexities of financial data are big challenges for forensic accounting. This paper presents a comprehensive review of the literature on the application of data mining techniques for the detection of financial accounting fraud and proposes a framework for data mining techniques based accounting fraud detection. The systematic and comprehensive literature review of the data mining techniques applicable to financial accounting fraud detection may provide a foundation to future research in this field. The findings of this review show that data mining techniques like logistic models, neural networks, Bayesian belief network, and decision trees have been applied most extensively to provide primary solutions to the problems inherent in the detection and classification of fraudulent data.

77 FR 46258 - Debit Card Interchange Fees and Routing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-03

... the types of fraud, methods used to commit fraud, and available fraud-prevention methods. An issuer... 920(a)(5) requires the Board to consider (1) the nature, type, and occurrence of fraud in electronic..., merchant trade associations, a card-payment processor, technology companies, a member of Congress...

75 FR 52944 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... records. Upon the effective date of this notice, system OFHEO-07, ``Mortgage Fraud System'' published at 71 FR 6085 on February 6, 2006 will be deleted. The proposed system named ``Fraud Reporting System'' (FHFA-6) will maintain information of fraud or possible fraud involving the Federal National Mortgage...

42 CFR 455.23 - Suspension of payments in cases of fraud.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Suspension of payments in cases of fraud. 455.23... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud Detection and Investigation Program § 455.23 Suspension of payments in cases of fraud. (a) Basis for...

Consumer Frauds and Deceptions: A Learning Module.

ERIC Educational Resources Information Center

Waddell, Fred E.; And Others

This manual is designed to assist helping professionals responsible for developing consumer education programs for older adults on the topic of consumer fraud and deception. In a modular presentation format, the materials address the following areas of concern: (1) types of frauds and deceptions such as money schemes, mail order fraud,…

78 FR 29055 - State Medicaid Fraud Control Units; Data Mining

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... Fraud Control Units (MFCU) from using Federal matching funds to identify fraud through screening and... Control Number (OCN) 0990-0162. Table 2 indicates the paperwork burden associated with the requirements of...

The ZeroAccess Auto-Clicking and Search-Hijacking Click Fraud Modules

DTIC Science & Technology

2013-12-16

payloads and instead began distributing Bitcoin miners and click fraud modules.3 From a technical perspective, the primary click fraud malware used in...this era operated in the indiscriminate “auto-clicking” fashion we describe in Section 5. Alongside the click fraud and Bitcoin payloads, ZeroAccess

32 CFR 516.67 - Overseas cases of fraud or corruption.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Overseas cases of fraud or corruption. 516.67... AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.67 Overseas cases of fraud or corruption. (a) Commanders of overseas major commands will establish procedures...

Fraud prevention in paying portal

NASA Astrophysics Data System (ADS)

Sandhu, P. S.; Senthilkumar, N. C.

2017-11-01

The purpose of presenting this paper is to give the idea to prevent the fraud in finance paying portals as fraud is increasing on daily basis and mostly in financial sector. So through this paper we are trying to prevent the fraud. This paper will give you the working algorithm through which you can able to prevent the fraud. Algorithm will work according to the spending amount of the user, which means that use will get categories into one of the low, medium, high or very high category.

Science as a Matter of Honour: How Accused Scientists Deal with Scientific Fraud in Japan.

PubMed

Pellegrini, Pablo A

2017-06-26

Practices related to research misconduct seem to have been multiplied in recent years. Many cases of scientific fraud have been exposed publicly, and journals and academic institutions have deployed different measures worldwide in this regard. However, the influence of specific social and cultural environments on scientific fraud may vary from society to society. This article analyzes how scientists in Japan deal with accusations of scientific fraud. For such a purpose, a series of scientific fraud cases that took place in Japan has been reconstructed through diverse sources. Thus, by analyzing those cases, the social basis of scientific fraud and the most relevant aspects of Japanese cultural values and traditions, as well as the concept of honour which is deeply involved in the way Japanese scientists react when they are accused of and publicly exposed in scientific fraud situations is examined.

Food Fraud Prevention: Policy, Strategy, and Decision-Making - Implementation Steps for a Government Agency or Industry.

PubMed

Spink, John; Fortin, Neal D; Moyer, Douglas C; Miao, Hong; Wu, Yongning

2016-01-01

This paper addresses the role of governments, industry, academics, and non-governmental organizations in Food Fraud prevention. Before providing strategic concepts for governments and authorities, definitions of Food Fraud are reviewed and discussed. Next there is a review of Food Fraud activities by the Global Food Safety Initiative (GFSI), the Elliott Review in the United Kingdom, the European Commission resolution on Food Fraud, and the US Food Safety Modernization Act including the Preventative Controls Rule. Two key concepts for governments or a company are: (1) formally, and specifically, mention food fraud as a food issue and (2) create an enterprise-wide Food Fraud prevention plan. The research includes a case study of the implementation of the concepts by a state or provincial agency. This analysis provides a foundation to review the role of science and technology in detection, deterrence and then contributing to prevention.

Your business in court: 2009-2010.

PubMed

Reiss, John B; Hall, Christopher R; Wartman, Gregory J

2011-01-01

During this period, FDA focused considerable effort on its transparency initiative, which is likely to continue into the coming year, as well as continuing to ramp up its enforcement activities, as we predicted last year. The scope of the agency's ability to pre-empt state laws in product liability litigation involving pharmaceutical products still is developing post-Levine, and we are likely to see new decisions in the coming year. Fraud and abuse enforcement still is a major factor facing the industry, with the added threat of personal exposure to criminal sentences, fines and debarment from participation in federal and state programs under the Responsible Corporate Officer doctrine, or under the authorities exercised by the Department of Health and Human Services Office of the Inspector General. Consequently, it is increasingly important that senior corporate officers ensure active oversight of an effective compliance program which should mitigate these risks. The Federal Trade Commission continues to battle consumer fraud, particularly respecting weight loss programs, and it appears to be fighting a losing battle in its effort to prevent "reverse" payments to generic manufacturers by Innovator Manufacturers to delay the introduction of generics to the market. The Securities and Exchange Commission continues to be actively enforcing the Foreign Corrupt Practices Act. The Supreme Court gave shareholders more leeway in bringing stockholder suits in situations where a company conceals information that, if revealed, could have a negative effect on stock prices.

An Overview of a Hybrid Fraud Scoring and Spike Detection Technique for Fraud Detection in Streaming Data

NASA Astrophysics Data System (ADS)

Laleh, Naeimeh; Azgomi, Mohammad Abdollahi

Credit card and personal loan applications have increased significantly. Application fraud is present when the application forms contain plausible and synthetic identity information or real stolen identity information. The monetary cost of application fraud is often estimated to be in the billions of dollars [1].

42 CFR 1001.201 - Conviction relating to program or health care fraud.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Conviction relating to program or health care fraud... Permissive Exclusions § 1001.201 Conviction relating to program or health care fraud. (a) Circumstance for... misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial...

42 CFR 1001.201 - Conviction relating to program or health care fraud.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Conviction relating to program or health care fraud... Permissive Exclusions § 1001.201 Conviction relating to program or health care fraud. (a) Circumstance for... misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial...

75 FR 2105 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... Inspector General Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical... Register notice sets forth the recently issued OIG Updated Special Fraud Alert addressing telemarketing by durable medical equipment (DME) suppliers. For the most part, OIG Special Fraud Alerts address national...

76 FR 81904 - Solicitation of New Safe Harbors and Special Fraud Alerts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... Special Fraud Alerts. DATES: To assure consideration, public comments must be delivered to the address... and Special Fraud Alerts. Please assist us by referencing the file code OIG-120-N. Inspection of...

Fraud Prevention and Employee Rationalization in New York State Public Schools

ERIC Educational Resources Information Center

Slezak, Kathleen

2013-01-01

Prompted by frequent media reports of school fraud and a lack of relevant K-12 literature, this research study was designed to investigate current fraud prevention practices in public school districts in New York State. Using a "fraud triangle" model, an analysis of existing legislation and professional practice guidelines reveals that…

A Social Marketing Campaign in Denver: Reducing the Risk of Elder Fraud

ERIC Educational Resources Information Center

McKenna, Judy; Miller, Jacque; Curtis, Lisa

2004-01-01

Acknowledging the pain and loss senior citizens experience due to fraud, the Denver District Attorney's Office launched a campaign--"Clergy Against Senior Exploitation (CASE)"--to reduce fraud perpetrated on older persons. The thrust of this project was preventing fraud by educating older adults through their religious affiliations in…

Education Department Auditor Doesn't See Loan Abuses Retiring with Him

ERIC Educational Resources Information Center

Basken, Paul

2008-01-01

As he begins retirement this month after 40 years of federal service, the Education Department's departing inspector general, John P. Higgins Jr., sees one area that stands out for its susceptibility to costly waste and abuse. That area, Higgins said in an interview as he finished packing up his office, is student lending. Unless Congress greatly…

48 CFR 252.203-7001 - Prohibition on persons convicted of fraud or other defense-contract-related felonies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... convicted of fraud or other defense-contract-related felonies. 252.203-7001 Section 252.203-7001 Federal... convicted of fraud or other defense-contract-related felonies. As prescribed in 203.570-3, use the following clause: Prohibition on Persons Convicted of Fraud or Other Defense-Contract-Related Felonies (DEC 2008...

78 FR 78807 - Solicitation of New Safe Harbors and Special Fraud Alerts

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-122-N...

77 FR 76434 - Solicitation of New Safe Harbors and Special Fraud Alerts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-121-N...

Developmental trajectories of offenders convicted of fraud: A follow-up to age 50 in a Dutch conviction cohort

PubMed Central

van der Geest, Victor R.; Weisburd, David; Blokland, Arjan A. J.

2016-01-01

This study describes the criminal careers of offenders convicted of fraud, distinguishing different career dimensions such as intermittency, versatility and specialization. Results indicate that most fraud offenders are versatile in the sense that they also have significant criminal records for other serious offending (that is, not fraud). At the same time they are also specialized in fraud. When we examine developmental trajectories of serious offending and next explore patterns of fraud for the groups identified, we find that offenders in our sample represent a heterogeneous group and that the classic divide between typical financial (for example, white-collar) offenders and common criminals does not apply to the majority of our sample. PMID:28989326

Retractions in the scientific literature: is the incidence of research fraud increasing?

PubMed

Steen, R Grant

2011-04-01

Scientific papers are retracted for many reasons including fraud (data fabrication or falsification) or error (plagiarism, scientific mistake, ethical problems). Growing attention to fraud in the lay press suggests that the incidence of fraud is increasing. The reasons for retracting 742 English language research papers retracted from the PubMed database between 2000 and 2010 were evaluated. Reasons for retraction were initially dichotomised as fraud or error and then analysed to determine specific reasons for retraction. Error was more common than fraud (73.5% of papers were retracted for error (or an undisclosed reason) vs 26.6% retracted for fraud). Eight reasons for retraction were identified; the most common reason was scientific mistake in 234 papers (31.5%), but 134 papers (18.1%) were retracted for ambiguous reasons. Fabrication (including data plagiarism) was more common than text plagiarism. Total papers retracted per year have increased sharply over the decade (r=0.96; p<0.001), as have retractions specifically for fraud (r=0.89; p<0.001). Journals now reach farther back in time to retract, both for fraud (r=0.87; p<0.001) and for scientific mistakes (r=0.95; p<0.001). Journals often fail to alert the naïve reader; 31.8% of retracted papers were not noted as retracted in any way. Levels of misconduct appear to be higher than in the past. This may reflect either a real increase in the incidence of fraud or a greater effort on the part of journals to police the literature. However, research bias is rarely cited as a reason for retraction.

FraudMiner: A Novel Credit Card Fraud Detection Model Based on Frequent Itemset Mining

PubMed Central

Seeja, K. R.; Zareapoor, Masoumeh

2014-01-01

This paper proposes an intelligent credit card fraud detection model for detecting fraud from highly imbalanced and anonymous credit card transaction datasets. The class imbalance problem is handled by finding legal as well as fraud transaction patterns for each customer by using frequent itemset mining. A matching algorithm is also proposed to find to which pattern (legal or fraud) the incoming transaction of a particular customer is closer and a decision is made accordingly. In order to handle the anonymous nature of the data, no preference is given to any of the attributes and each attribute is considered equally for finding the patterns. The performance evaluation of the proposed model is done on UCSD Data Mining Contest 2009 Dataset (anonymous and imbalanced) and it is found that the proposed model has very high fraud detection rate, balanced classification rate, Matthews correlation coefficient, and very less false alarm rate than other state-of-the-art classifiers. PMID:25302317

FraudMiner: a novel credit card fraud detection model based on frequent itemset mining.

PubMed

Seeja, K R; Zareapoor, Masoumeh

2014-01-01

This paper proposes an intelligent credit card fraud detection model for detecting fraud from highly imbalanced and anonymous credit card transaction datasets. The class imbalance problem is handled by finding legal as well as fraud transaction patterns for each customer by using frequent itemset mining. A matching algorithm is also proposed to find to which pattern (legal or fraud) the incoming transaction of a particular customer is closer and a decision is made accordingly. In order to handle the anonymous nature of the data, no preference is given to any of the attributes and each attribute is considered equally for finding the patterns. The performance evaluation of the proposed model is done on UCSD Data Mining Contest 2009 Dataset (anonymous and imbalanced) and it is found that the proposed model has very high fraud detection rate, balanced classification rate, Matthews correlation coefficient, and very less false alarm rate than other state-of-the-art classifiers.

Role of dental expert in forensic odontology

PubMed Central

Verma, Anoop K.; Kumar, Sachil; Rathore, Shiuli; Pandey, Abhishek

2014-01-01

Forensic dentistry has become an integral part of forensic science over the past 100 years that utilizes dental or oro-facial findings to serve the judicial system. This has been due to the dedication of people like Gustafson's, Keiser-Nielson, and Suzuki for this field. They established the essential role which forensic dentistry plays mainly in the identification of human remains. The tooth has been used as weapons and under certain circumstances, may leave information about the identity of the biter. Dental professionals have a major role to play in keeping accurate dental records and providing all necessary information so that legal authorities may recognize mal practice, negligence, fraud or abuse, and identity of unknown individuals. This paper will try to summarize the various roles of dental experts in forensic medicine. PMID:25298709

78 FR 53168 - Agency Information Collection Activities: Submission to OMB for Reinstatement, Without Change, of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

...The NCUA intends to submit the following information collection to the Office of Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. This information collection relates to NCUA rules and regulations, which require a federal credit union (FCU) to monitor its eligibility to qualify for a higher fidelity coverage deductible and to notify the NCUA if its financial condition changes resulting in the loss of that eligibility for the higher deductible. This information collection notice is published to obtain comments from the public. This requirement enables NCUA to monitor the FCU's financial condition for safety and soundness purposes and helps to assure that FCUs are properly and adequately protected against potential losses due to insider abuse such as fraud and embezzlement.

Financial viability, medical technology, and hospital closures.

PubMed

Prince, T R; Sullivan, J A

2000-01-01

Informed investments in medical technology and information systems are associated with the financial viability of community hospitals. Financially distressed facilities are 3 to 4 years behind proactive hospitals in supporting high-speed data, voice, and image transmissions to physicians in various locations. Impact of the Balanced Budget Act of 1997, fraud and abuse activities, Y2K issues, and lack of information systems support for physicians will result in 800 hospital closures and mergers of distressed hospitals over the next 60 months. These findings are based on the application of an eight-step framework for classifying information systems in health care entities. This framework is validated by survey instruments, site visits, interviews with senior management in 44 health care entities containing 576 hospitals, and judgments on the financial status of the health care entities.

Health Fraud

MedlinePlus

Health fraud involves selling drugs, devices, foods, or cosmetics that have not been proven effective. Keep in ... you from getting the treatment you really need. Health fraud scams can be found everywhere, promising help ...

[Communication of scientific fraud].

PubMed

Zeitoun, Jean-David; Rouquette, Sébastien

2012-09-01

There is for a scientific journal several levels of communication depending of the degree of suspicion or certainty of a case of error or fraud. The task is increasingly difficult for journal editors as disclosed cases of fraud are more common and scientific communication on this topic is growing. Biomedical fraud is fairly little reported by the mainstream press and causes of this low interest are not currently well understood. The difficulty of processing this type of news for journalists appears to be one possible reason. The potentially numerous and significant consequences of fraud on health professionals are poorly documented. Though it is likely to cause a feeling of distrust and create controversy, the impact of fraud on the general public is poorly studied and appears multifactorial. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Legally Sustainable Solutions for Privacy Issues in Collaborative Fraud Detection

NASA Astrophysics Data System (ADS)

Flegel, Ulrich; Kerschbaum, Florian; Miseldine, Philip; Monakova, Ganna; Wacker, Richard; Leymann, Frank

One company by itself cannot detect all instances of fraud or insider attacks. An example is the simple case of buyer fraud: a fraudulent buyer colludes with a supplier creating fake orders for supplies that are never delivered. They circumvent internal controls in place to prevent this kind of fraud, such as a goods receipt, e.g., by ordering services instead of goods. Based on the evidence collected at one company, it is often extremely difficult to detect such fraud, but if companies collaborate and correlate their evidence, they could detect that the ordered services have never actually been provided.

41 CFR 102-38.50 - What must we do when an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or...

Code of Federal Regulations, 2010 CFR

2010-07-01

... executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in connection... an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in.... 559, fraud, bribery, or criminal collusion in connection with the disposal of personal property, the...

Strand IV: Environmental and Community Health. Environmental and Public Health, Grades 4-6. Special Edition for Evaluation and Discussion.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Elementary Curriculum Development.

This prototypic curriculum is designed to develop awareness of the challenges man faces in his crowded communities to insure clean water, pest control, waste removal, safe food handling and adequate community health facilities. It distinguishes between the prevention of future environmental abuse and compensation for past abuses. Both the gaining…

Online Safety: Fraud, Security, Phishing, Vishing

MedlinePlus

... Theft Online Safety Privacy Report Scams and Frauds Online Safety Be aware of these scams when you' ... Security and Safety Internet Fraud Phishing and Vishing Online Security and Safety The internet makes many everyday ...

An Analysis of Internal Controls and Procurement Fraud Deterrence

DTIC Science & Technology

2013-12-01

might keep the organization from achieving its objectives and analyze risks , including fraud risk , so as to decide how the risk should be managed ( COSO ...internal control to adequately manage the risk ( COSO , 2013). Risk management involves developing the effective internal control targeted at a...structure and management . While the risk of fraud cannot be eliminated entirely, it can be greatly reduced with an appropriate procurement fraud prevention

Fraud Detection in Healthcare

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chandola, Varun; Schryver, Jack C; Sukumar, Sreenivas R

We discuss the problem of fraud detection in healthcare in this chapter. Given the recent scrutiny of the ineciencies in the US healthcare system, identifying fraud has been on the forefront of the eorts towards reducing the healthcare costs. In this chapter we will focus on understanding the issue of healthcare fraud in detail, and review methods that have been proposed in the literature to combat this issue using data driven approach.

32 CFR 516.68 - Program Fraud Civil Remedies Act (PFCRA).

Code of Federal Regulations, 2010 CFR

2010-07-01

... AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.68 Program Fraud Civil Remedies Act (PFCRA). (a) PFCRA was enacted on 21 October 1986 (Public Law 99-509) and...

48 CFR 3032.006 - Reduction or suspension of contract payments upon finding of fraud.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contract payments upon finding of fraud. 3032.006 Section 3032.006 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) GENERAL CONTRACTING... finding of fraud. ...

Avoiding Service Station Fraud.

ERIC Educational Resources Information Center

Burton, Grace M.; Burton, John R.

1982-01-01

High school students are warned against service station fraud. A problem-solving section is designed to help students calculate consumer costs for various fraudulent transactions. Several ways of reducing fraud or of lessening the chances of problems are noted. (MP)

Procurement Integrity in Contingency Operations: A Case Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory

DTIC Science & Technology

2011-12-01

Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory By: Amanda H...Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory 6. AUTHOR(S) Amanda H. Flint 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION...CCOs) during Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) by applying occupational fraud theory, specifically the classic sociological

Does Medical School Training Relate to Practice? Evidence from Big Data.

PubMed

Feldman, Keith; Chawla, Nitesh V

2015-06-01

On April 2nd, 2014, the Department of Health and Human Services (HHS) announced a historic policy in its effort to increase the transparency in the American healthcare system. The Center for Medicare and Medicaid Service (CMS) would publicly release a dataset containing information about the types of Medicare services, requested charges, and payments issued by providers across the country. In its release, HHS stated that the data would shed light on "Medicare fraud, waste, and abuse." While this is most certainly true, we believe that it can provide so much more. Beyond the purely financial aspects of procedure charges and payments, the procedures themselves may provide us with additional information, not only about the Medicare population, but also about the physicians themselves. The procedures a physician performs are for the most part not novel, but rather recommended, observed, and studied. However, whether a physician decides on advocating a procedure is somewhat discretionary. Some patients require a clear course of action, while others may benefit from a variety of options. This article poses the following question: How does a physician's past experience in medical school shape his or her practicing decisions? This article aims to open the analysis into how data, such as the CMS Medicare release, can help further our understanding of knowledge transfer and how experiences during education can shape a physician's decision's over the course of his or her career. This work begins with an evaluation into similarities between medical school charges, procedures, and payments. It then details how schools' procedure choices may link them in other, more interesting ways. Finally, the article includes a geographic analysis of how medical school procedure payments and charges are distributed nationally, highlighting potential deviations.

Questionable, Objectionable or Criminal? Public Opinion on Data Fraud and Selective Reporting in Science.

PubMed

Pickett, Justin T; Roche, Sean Patrick

2018-02-01

Data fraud and selective reporting both present serious threats to the credibility of science. However, there remains considerable disagreement among scientists about how best to sanction data fraud, and about the ethicality of selective reporting. The public is arguably the largest stakeholder in the reproducibility of science; research is primarily paid for with public funds, and flawed science threatens the public's welfare. Members of the public are able to make meaningful judgments about the morality of different behaviors using moral intuitions. Legal scholars emphasize that to maintain legitimacy, social control policies must be developed with some consideration given to the public's moral intuitions. Although there is a large literature on popular attitudes toward science, there is no existing evidence about public opinion on data fraud or selective reporting. We conducted two studies-a survey experiment with a nationwide convenience sample (N = 821), and a follow-up survey with a representative sample of US adults (N = 964)-to explore community members' judgments about the morality of data fraud and selective reporting in science. The findings show that community members make a moral distinction between data fraud and selective reporting, but overwhelmingly judge both behaviors to be immoral and deserving of punishment. Community members believe that scientists who commit data fraud or selective reporting should be fired and banned from receiving funding. For data fraud, most Americans support criminal penalties. Results from an ordered logistic regression analysis reveal few demographic and no significant partisan differences in punitiveness toward data fraud.

Corruption and internal fraud in the Turkish construction industry.

PubMed

Gunduz, Murat; Önder, Oytun

2013-06-01

The purpose of this paper is to develop an understanding about the internal fraud and corruption problem in the Turkish construction industry. The reasons behind the internal fraud and corruption problem as well as the types of prevention methods were investigated; and as a result various recommendations were made. To this end, a risk awareness questionnaire was used to understand the behavioral patterns of the construction industry, and to clarify possible proactive and reactive measures against internal fraud and corruption. The type of fraud experienced by Turkish construction companies was also surveyed in the questionnaire. The questionnaire was sent to 89 firms; and depending on the collected data, certain recommendations for construction industry professionals were provided.

[Scientific fraud. A disease we find among ourselves].

PubMed

Guimarães, S

1998-01-01

Scientific fraud is not a problem exclusive to countries with high scientific development. Fraud does not necessarily mean invention of results, usurpation of ideas, manifest plagiarism or any other kind of serious scientific misconduct. Although more rare in countries where scientific production is more modest, pungent cases of scientific fraud also exist. However, less notorious cases of scientific misconduct are frequent and must be avoided. Examples of these less notorious sins are presented. The seriousness of scientific fraud is not only due to the fact that it may involve public funds, which could have been put to more useful purposes but, above all, because it violates scientific ethics and frustrates the final aim of science, the discovery of truth.

Fraud and plagiarisim in school and career.

PubMed

Agud, J L

2014-10-01

Between 0% and 94% of university students acknowledge having committed academic fraud. Its forms are varied: cheating on examinations, submitting someone else's work, plagiarism, false citations, false reporting on experiments, tests or findings in the medical history and physical examination, unfair behavior toward fellow students, and many others. The consequences of academic fraud include learning corruption, useless efforts by students and faculty, incorrect performance evaluations and unfair selection for jobs. Since this can be a prelude to future fraud as doctors or researches, the prevalence, risk factors, motivations, clinical appearances, detection and prevention of the disease of academic fraud are here reviewed. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

AICPA standard aids in detecting risk factors for fraud. American Institute of Certified Public Accountants.

PubMed

Reinstein, A; Dery, R J

1999-10-01

The American Institute of Certified Public Accountants' Statement on Auditing Standards (SAS) No. 82, Consideration of Fraud in a Financial Statement Audit, requires independent auditors to obtain reasonable assurance that financial statements are free of material mis-statements caused by error or fraud. SAS No. 82 provides guidance for independent auditors to use to help detect and document risk factors related to potential fraud. But while SAS No. 82 suggests how auditors should assess the potential for fraud, it does not expand their detection responsibility. Accordingly, financial managers should discuss thoroughly with auditors the scope and focus of an audit as a means to further their compliance efforts.

Fraud and fiduciary liability.

PubMed

Hodge, Brian Ray

2003-12-01

All employee benefit plans are potential targets of fraudulent schemes. Smaller plans are targeted by unscrupulous brokers and promoters selling fraudulent policies; plans large enough to be self-insured face greater risks of fraud by providers and participants misrepresenting claims. Plan trustees, administrators and consultants should be alert to the many ways fraudulent schemes manifest themselves and to the legal remedies available; establish investigative programs to detect and discourage fraud; and promote education and plan incentives for participants to report fraud.

Credit Card Fraud Detection: A Realistic Modeling and a Novel Learning Strategy.

PubMed

Dal Pozzolo, Andrea; Boracchi, Giacomo; Caelen, Olivier; Alippi, Cesare; Bontempi, Gianluca

2017-09-14

Detecting frauds in credit card transactions is perhaps one of the best testbeds for computational intelligence algorithms. In fact, this problem involves a number of relevant challenges, namely: concept drift (customers' habits evolve and fraudsters change their strategies over time), class imbalance (genuine transactions far outnumber frauds), and verification latency (only a small set of transactions are timely checked by investigators). However, the vast majority of learning algorithms that have been proposed for fraud detection rely on assumptions that hardly hold in a real-world fraud-detection system (FDS). This lack of realism concerns two main aspects: 1) the way and timing with which supervised information is provided and 2) the measures used to assess fraud-detection performance. This paper has three major contributions. First, we propose, with the help of our industrial partner, a formalization of the fraud-detection problem that realistically describes the operating conditions of FDSs that everyday analyze massive streams of credit card transactions. We also illustrate the most appropriate performance measures to be used for fraud-detection purposes. Second, we design and assess a novel learning strategy that effectively addresses class imbalance, concept drift, and verification latency. Third, in our experiments, we demonstrate the impact of class unbalance and concept drift in a real-world data stream containing more than 75 million transactions, authorized over a time window of three years.

Financial fraud and health: the case of Spain.

PubMed

Zunzunegui, Maria Victoria; Belanger, Emmanuelle; Benmarhnia, Tarik; Gobbo, Milena; Otero, Angel; Béland, François; Zunzunegui, Fernando; Ribera-Casado, Jose Manuel

To examine whether financial fraud is associated with poor health sleeping problems and poor quality of life. Pilot study (n=188) conducted in 2015-2016 in Madrid and León (Spain) by recruiting subjects affected by two types of fraud (preferred shares and foreign currency mortgages) using venue-based sampling. Information on the monetary value of each case of fraud; the dates when subjects became aware of being swindled, lodged legal claim and received financial compensation were collected. Inter-group comparisons of the prevalence of poor physical and mental health, sleep and quality of life were carried according to type of fraud and the 2011-2012 National Health Survey. In this conventional sample, victims of financial fraud had poorer health, more mental health and sleeping problems, and poorer quality of life than comparable populations of a similar age. Those who had received financial compensation for preferred share losses had better health and quality of life than those who had not been compensated and those who had taken out foreign currency mortgages. The results suggest that financial fraud is detrimental to health. Further research should examine the mechanisms through which financial fraud impacts health. If our results are confirmed psychological and medical care should be provided, in addition to financial compensation. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Report: EPA Did Not Identify Volkswagen Emissions Cheating; Enhanced Controls Now Provide Reasonable Assurance of Fraud Detection

EPA Pesticide Factsheets

Report #18-P-0181, May 15, 2018. After uncovering VW's emissions fraud, the EPA's light-duty vehicle compliance program added controls to effectively detect and prevent noncompliance—a precursor to potential fraud.

The Need for Specific Penalties for Hacking in Criminal Law

PubMed Central

Oh, Sangkyo; Lee, Kyungho

2014-01-01

In spite of the fact that hacking is a widely used term, it is still not legally established. Moreover, the definition of the concept of hacking has been deployed in a wide variety of ways in national literature. This ambiguity has led to various side effects. Recently in the United States, reforms collectively known as Aaron's Law were proposed as intended amendments to the Computer Fraud and Abuse Act (CFAA). Most experts expect that this change will put the brakes on the CFAA as a severe punishment policy, and result in a drop in controversial court decisions. In this study, we analyze the definitions and the penalties for hacking for each country and compare them with the national law and then make suggestions through more specific legislation. We expect it will reduce legal controversy and prevent excessive punishment. PMID:25032236

The need for specific penalties for hacking in criminal law.

PubMed

Oh, Sangkyo; Lee, Kyungho

2014-01-01

In spite of the fact that hacking is a widely used term, it is still not legally established. Moreover, the definition of the concept of hacking has been deployed in a wide variety of ways in national literature. This ambiguity has led to various side effects. Recently in the United States, reforms collectively known as Aaron's Law were proposed as intended amendments to the Computer Fraud and Abuse Act (CFAA). Most experts expect that this change will put the brakes on the CFAA as a severe punishment policy, and result in a drop in controversial court decisions. In this study, we analyze the definitions and the penalties for hacking for each country and compare them with the national law and then make suggestions through more specific legislation. We expect it will reduce legal controversy and prevent excessive punishment.

Spy the Lie: Detecting Malicious Insiders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Noonan, Christine F.

Insider threat is a hard problem. There is no ground truth, there are innumerable variables, and the data is sparse. The types of crimes and abuses associated with insider threats are significant; the most serious include espionage, sabotage, terrorism, embezzlement, extortion, bribery, and corruption. Malicious activities include an even broader range of exploits, such as negligent use of classified data, fraud, cybercrime, unauthorized access to sensitive information, and illicit communications with unauthorized recipients. Inadvertent action or inaction without malicious intent (e.g., disposing of sensitive documents incorrectly) can also cause harm to an organization. This review article will explore insider threat,more » specifically behaviors, beliefs, and current debates within the field. Additionally particular focus is given to deception, a significant behavioral component of the malicious insider. Finally, research and policy implications for law enforcement and the intelligence community are addressed.« less

Medicare and Social Security: fraud and abuse; civil money penalties for misuse of certain terms, symbols and emblems--HHS. Final rule.

PubMed

1991-08-28

This final rule implements section 428(a) of Public Law 100-360 which authorizes the imposition of civil money penalties for the use--in advertising, solicitations or other communications--of certain words, letters, symbols or emblems associated with the Department of Health and Human Services' Social Security and Medicare programs in a manner that the user knows, or should know, would convey a false impression that (1) the communicated item was approved, endorsed or authorized by the Department or its programs, or (2) the responsible person or organization has some connection with, or authorization from, the Department or these programs. This rulemaking is designed to assist in protecting citizens from misrepresentations concerning the services offered and programs administered by the Social Security Administration and the Health Care Financing Administration.

49 CFR 1540.103 - Fraud and intentional falsification of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY CIVIL AVIATION SECURITY: GENERAL RULES Responsibilities of Passengers and Other Individuals and Persons § 1540.103 Fraud... 49 Transportation 9 2010-10-01 2010-10-01 false Fraud and intentional falsification of records...

Implementing US-style anti-fraud laws in the Australian pharmaceutical and health care industries.

PubMed

Faunce, Thomas A; Urbas, Gregor; Skillen, Lesley

2011-05-02

This article critically analyses the prospects for introducing United States anti-fraud (or anti-false claims) laws in the Australian health care setting. Australian governments spend billions of dollars each year on medicines and health care. A recent report estimates that the money lost to corporate fraud in Australia is growing at an annual rate of 7%, but that only a third of the losses are currently being detected. In the US, qui tam provisions - the component of anti-fraud or anti-false claims laws involving payments to whistleblowers - have been particularly successful in providing critical evidence allowing public prosecutors to recover damages for fraud and false claims made by corporations in relation to federal and state health care programs. The US continues to strengthen such anti-fraud measures and to successfully apply them to a widening range of areas involving large public investment. Australia still suffers from the absence of any comprehensive scheme that not only allows treble damages recovery for fraud on the public purse, but crucially supports such actions by providing financial encouragement for whistleblowing corporate insiders to expose evidence of fraud. Potential areas of application could include direct and indirect government expenditure on health care service provision, pharmaceuticals, medical devices, defence, carbon emissions compensation and tobacco-related illness. The creation in Australia of an equivalent to US anti-false claims legislation should be a policy priority, particularly in a period of financial stringency.

Fighting Fraud in Schools

ERIC Educational Resources Information Center

Dessoff, Alan

2009-01-01

It's no surprise that school districts are as vulnerable to fraud as the private sector or any other segment of government. Crimes in districts include collusion with outside vendors who provide kickbacks to employees, misuse of district-issued credit cards, embezzlement of district funds, and theft of district property. "Fraud happens…

Fraud Education for Accounting Students.

ERIC Educational Resources Information Center

Peterson, Bonita K.

2003-01-01

Reports that limited fraud education takes place in accounting due to a crowded curriculum and misunderstanding of the extent of fraud. Suggests ways to develop content on the topic and provides a list of teaching materials (textbooks, workbooks, trade books, case materials, videos, and reference materials). (Contains 16 references.) (SK)

76 FR 7239 - Proposed Privacy Act Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-09

... property interests, identity theft or fraud, or harm to the security or integrity of this system or other... notice of a proposed system of records entitled, ``Treasury/DO .225 --TARP Fraud Investigation...: Supervisory Fraud Specialist, Office of Financial Stability, 1500 Pennsylvania Avenue, NW., Washington, DC...

Electronic Fraud on Campus.

ERIC Educational Resources Information Center

Sauter, David M.

1998-01-01

It is surprisingly easy for today's students to change grades, falsify documents, or create bogus diplomas. Explores the extent of the problem and offers ideas on ways in which colleges can protect themselves and society from the consequences of educational fraud. Addresses staff training, distribution of information regarding fraud, and improving…

49 CFR 1522.3 - Fraud and intentional falsification of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Fraud and intentional falsification of records...) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY SECURITY RULES FOR ALL MODES OF TRANSPORTATION TSA-APPROVED VALIDATION FIRMS AND VALIDATORS General § 1522.3 Fraud and intentional falsification...

76 FR 5212 - Employment and Training Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Collection for Internal Fraud and Overpayment Detection and Recovery Activities (OMB Control No. 1205-0187... of data on a revised form ETA 9000 that provides information about Internal Fraud and Overpayment...: I. Background The ETA 9000 is the only data source available on: (1) Instances of internal fraud...

When Good Money Goes Bad: True Stories of Contract Fraud at EPA

EPA Pesticide Factsheets

In an effort to provide you with tools to identify areas that may be of concern or worth looking into, this booklet was designed to provide an overview of general fraud indicators as well as highlight some specific indicators related to contract fraud.

7 CFR 226.25 - Other provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... result of funds received under the Act. (e) Fraud penalty. Whoever embezzles, willfully misapplies, steals, or obtains by fraud any funds, assets, or property that are the subject of a grant or other form..., assets, or property have been embezzled, willfully misapplied, stolen, or obtained by fraud shall, if...

7 CFR 226.25 - Other provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... result of funds received under the Act. (e) Fraud penalty. Whoever embezzles, willfully misapplies, steals, or obtains by fraud any funds, assets, or property that are the subject of a grant or other form..., assets, or property have been embezzled, willfully misapplied, stolen, or obtained by fraud shall, if...

7 CFR 225.18 - Miscellaneous administrative provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... receive approval from FNSRO. (g) Fraud penalty. Whoever embezzles, willfully misapplies, steals, or obtains by fraud any funds, assets, or property that are the subject of a grant or other form of... property have been embezzled, willfully misapplied, stolen or obtained by fraud shall, if such funds...

48 CFR 949.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 949.106 Section 949.106 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 949.106 Fraud or other criminal conduct. Any evidence...

48 CFR 1449.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 1449.106 Section 1449.106 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 1449.106 Fraud or other criminal conduct...

48 CFR 649.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 649.106 Section 649.106 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles. 649.106 Fraud or other criminal conduct. If the...

48 CFR 1349.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 1349.106 Section 1349.106 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 1349.106 Fraud or other criminal conduct. If the...

48 CFR 49.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 49.106 Section 49.106 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.106 Fraud or other criminal conduct. If...

7 CFR 1580.504 - Fraud and recovery of overpayments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Fraud and recovery of overpayments. 1580.504 Section 1580.504 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.504 Fraud and recovery...

32 CFR 516.62 - PFD and HQ USACIDC coordination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.62 PFD and HQ... procurement fraud or corruption investigations being conducted by USACIDC and possible remedies. These... affected by a significant investigation of fraud or corruption that relates to DOD procurement activities...

When Good Money Goes Bad: True Stories of Grant Fraud at EPA

EPA Pesticide Factsheets

In an effort to provide you with tools to identify areas that may be of concern or worth looking into, this booklet was designed to provide an overview of general fraud indicators as well as highlight some specific indicators related to grant fraud.

32 CFR 516.60 - Procurement fraud and irregularities programs at MACOMs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Procurement fraud and irregularities programs at MACOMs. 516.60 Section 516.60 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption...

20 CFR 356.2 - Program Fraud Civil Remedies Act of 1986.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Program Fraud Civil Remedies Act of 1986. 356.2 Section 356.2 Employees' Benefits RAILROAD RETIREMENT BOARD ADMINISTRATIVE REMEDIES FOR FRAUDULENT CLAIMS OR STATEMENTS CIVIL MONETARY PENALTY INFLATION ADJUSTMENT § 356.2 Program Fraud Civil Remedies Act...

42 CFR 455.21 - Cooperation with State Medicaid fraud control units.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with State Medicaid fraud control units. 455.21 Section 455.21 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud...

17 CFR 32.9 - Fraud in connection with commodity option transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Fraud in connection with commodity option transactions. 32.9 Section 32.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION REGULATION OF COMMODITY OPTION TRANSACTIONS § 32.9 Fraud in connection with commodity...

17 CFR 33.10 - Fraud in connection with commodity option transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Fraud in connection with commodity option transactions. 33.10 Section 33.10 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION REGULATION OF DOMESTIC EXCHANGE-TRADED COMMODITY OPTION TRANSACTIONS § 33.10 Fraud in...

49 CFR 1570.5 - Fraud and intentional falsification of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Fraud and intentional falsification of records...) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY MARITIME AND LAND TRANSPORTATION SECURITY GENERAL RULES § 1570.5 Fraud and intentional falsification of records. No person may make, cause to be...

Transcript Fraud and Handling Fraudulent Documents

ERIC Educational Resources Information Center

Ezell, Allen

2005-01-01

Transcript fraud is a common problem for colleges and universities, businesses, employers, governmental licensing boards, and other agencies, with some experiencing it more so than others. The only difference between a large and small institution is the volume of degree and transcript fraud it experiences. This article discusses the types and…

48 CFR 449.106 - Fraud or other criminal conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Fraud or other criminal conduct. 449.106 Section 449.106 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 449.106 Fraud or other criminal conduct. (a) If the...

Consumer Fraud: An Empirical Perspective. Summary.

ERIC Educational Resources Information Center

Schubert, Jane G.; And Others

The American Institutes for Research (AIR) and the National Consumer Law Center (NCLC) studied consumer fraud and assessed possible intervention. Phase I produced an AIR description of the nature, scope, and characteristics of consumer fraud and an NCLC compilation of the laws and regulations which control it. In Phase II AIR developed…

29 CFR 453.12 - Meaning of fraud or dishonesty.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE BONDING REQUIREMENTS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Scope of the Bond § 453.12 Meaning of fraud or dishonesty. The term “fraud or...

29 CFR 453.12 - Meaning of fraud or dishonesty.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE BONDING REQUIREMENTS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Scope of the Bond § 453.12 Meaning of fraud or dishonesty. The term “fraud or...

29 CFR 453.12 - Meaning of fraud or dishonesty.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE BONDING REQUIREMENTS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Scope of the Bond § 453.12 Meaning of fraud or dishonesty. The term “fraud or...

29 CFR 453.12 - Meaning of fraud or dishonesty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE BONDING REQUIREMENTS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Scope of the Bond § 453.12 Meaning of fraud or dishonesty. The term “fraud or...

29 CFR 453.12 - Meaning of fraud or dishonesty.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE BONDING REQUIREMENTS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Scope of the Bond § 453.12 Meaning of fraud or dishonesty. The term “fraud or...

32 CFR 516.60 - Procurement fraud and irregularities programs at MACOMs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Procurement fraud and irregularities programs at MACOMs. 516.60 Section 516.60 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption...

Detecting Health Fraud in the Field of Learning Disabilities.

ERIC Educational Resources Information Center

Worrall, Russell S.

1990-01-01

This article discusses health fraud in special education. Psychopathology of health fraud, standards by which pseudoscience and quackery are defined, and the complexities of learning disorders are considered. A scale to determine whether an alternative therapy is reasonable is presented. Several popular therapies are used as examples. (Author/PB)

33 CFR 53.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... regulation (including sexual harassment or discrimination), gross mismanagement, a gross waste of funds or other resources, an abuse of authority, or a substantial and specific danger to public health or safety...

The puzzle of monogamous marriage

PubMed Central

Henrich, Joseph; Boyd, Robert; Richerson, Peter J.

2012-01-01

The anthropological record indicates that approximately 85 per cent of human societies have permitted men to have more than one wife (polygynous marriage), and both empirical and evolutionary considerations suggest that large absolute differences in wealth should favour more polygynous marriages. Yet, monogamous marriage has spread across Europe, and more recently across the globe, even as absolute wealth differences have expanded. Here, we develop and explore the hypothesis that the norms and institutions that compose the modern package of monogamous marriage have been favoured by cultural evolution because of their group-beneficial effects—promoting success in inter-group competition. In suppressing intrasexual competition and reducing the size of the pool of unmarried men, normative monogamy reduces crime rates, including rape, murder, assault, robbery and fraud, as well as decreasing personal abuses. By assuaging the competition for younger brides, normative monogamy decreases (i) the spousal age gap, (ii) fertility, and (iii) gender inequality. By shifting male efforts from seeking wives to paternal investment, normative monogamy increases savings, child investment and economic productivity. By increasing the relatedness within households, normative monogamy reduces intra-household conflict, leading to lower rates of child neglect, abuse, accidental death and homicide. These predictions are tested using converging lines of evidence from across the human sciences. PMID:22271782

Defining the public health threat of food fraud.

PubMed

Spink, John; Moyer, Douglas C

2011-01-01

Food fraud, including the more defined subcategory of economically motivated adulteration, is a food risk that is gaining recognition and concern. Regardless of the cause of the food risk, adulteration of food is both an industry and a government responsibility. Food safety, food fraud, and food defense incidents can create adulteration of food with public health threats. Food fraud is an intentional act for economic gain, whereas a food safety incident is an unintentional act with unintentional harm, and a food defense incident is an intentional act with intentional harm. Economically motivated adulteration may be just that-economically motivated-but the food-related public health risks are often more risky than traditional food safety threats because the contaminants are unconventional. Current intervention systems are not designed to look for a near infinite number of potential contaminants. The authors developed the core concepts reported here following comprehensive research of articles and reports, expert elicitation, and an extensive peer review. The intent of this research paper is to provide a base reference document for defining food fraud-it focuses specifically on the public health threat-and to facilitate a shift in focus from intervention to prevention. This will subsequently provide a framework for future quantitative or innovative research. The fraud opportunity is deconstructed using the criminology and behavioral science applications of the crime triangle and the chemistry of the crime. The research provides a food risk matrix and identifies food fraud incident types. This project provides a starting point for future food science, food safety, and food defense research. Food fraud, including the more defined subcategory of economically motivated adulteration, is a food protection threat that has not been defined or holistically addressed. The terrorist attacks of September 11, 2001, led to the development of food defense as an autonomous area of study and a new food protection discipline. As economically motivated adulteration grows in scope, scale, and awareness, it is conceivable that food fraud will achieve the same status as an autonomous concept, between food safety and food defense. This research establishes a starting point for defining food fraud and identifying the public health risks. © 2011 Institute of Food Technologists®

32 CFR 516.67 - Overseas cases of fraud or corruption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Overseas cases of fraud or corruption. 516.67 Section 516.67 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.67 Overseas...

Playing the Ponies: A $5 Million Embezzlement Case

ERIC Educational Resources Information Center

Howe, Martha A.; Malgwi, Charles A.

2006-01-01

Fraud is a pervasive problem, and educating future business leaders, managers, and auditors about fraud is one way to attack the problem. This instructional fraud case chronicles the actual details surrounding a major embezzlement at a regional high school (RHS) that culminated in long federal and state prison sentences for the school's treasurer.…

13 CFR 142.8 - What happens if program fraud is suspected?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What happens if program fraud is suspected? 142.8 Section 142.8 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD... demanded in the false claim or statement; (5) Any exculpatory or mitigating circumstances that may relate...

Reducing Fraudulent Financial Reporting: An Expanded Role for Business Education in the 1990s.

ERIC Educational Resources Information Center

Urbancic, Frank R.

1988-01-01

The author reports findings of the National Commission on Fraudulent Financial Reporting concerning the role of business education in reducing fraud in financial reporting. Issues covered include teaching financial regulations, developing skills needed to detect fraud, teaching ethical values, and preparing faculty to teach about financial fraud.…

45 CFR 681.5 - What happens if program fraud is suspected?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... What happens if program fraud is suspected? (a) If the investigating official concludes that an action...

10 CFR 1015.103 - Antitrust, fraud, tax, interagency, transportation account audit, acquisition contract, and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... does not apply to tax debts. (c) Part 1015 does not apply to claims between Federal agencies. Federal... 10 Energy 4 2010-01-01 2010-01-01 false Antitrust, fraud, tax, interagency, transportation account... General § 1015.103 Antitrust, fraud, tax, interagency, transportation account audit, acquisition contract...

48 CFR 252.203-7004 - Display of fraud hotline poster(s).

Code of Federal Regulations, 2012 CFR

2012-10-01

... poster(s). 252.203-7004 Section 252.203-7004 Federal Acquisition Regulations System DEFENSE ACQUISITION... of Provisions And Clauses 252.203-7004 Display of fraud hotline poster(s). As prescribed in 203.1004(b)(2)(ii), use the following clause: Display of Fraud Hotline Poster(s) (SEP 2011) (a) Definition...

76 FR 57671 - Defense Federal Acquisition Regulation Supplement; Display of DoD Inspector General Fraud Hotline...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... General Fraud Hotline Posters AGENCY: Defense Acquisition Regulations System, Department of Defense (DoD... Regulation Supplement (DFARS) to require contractors to display the DoD fraud hotline poster in common work....203-14, Display of Hotline Poster(s). Government Accountability Office (GAO) Report GAO-09-591...

48 CFR 252.203-7004 - Display of fraud hotline poster(s).

Code of Federal Regulations, 2011 CFR

2011-10-01

... poster(s). 252.203-7004 Section 252.203-7004 Federal Acquisition Regulations System DEFENSE ACQUISITION... of Provisions And Clauses 252.203-7004 Display of fraud hotline poster(s). As prescribed in 203.1004(b)(2)(ii), use the following clause: Display of Fraud Hotline Poster(s) (Sep 2011) (a) Definition...

48 CFR 252.203-7004 - Display of fraud hotline poster(s).

Code of Federal Regulations, 2013 CFR

2013-10-01

... poster(s). 252.203-7004 Section 252.203-7004 Federal Acquisition Regulations System DEFENSE ACQUISITION... of Provisions And Clauses 252.203-7004 Display of fraud hotline poster(s). As prescribed in 203.1004(b)(2)(ii), use the following clause: Display of Fraud Hotline Poster(s) (DEC 2012) (a) Definition...

48 CFR 252.203-7004 - Display of fraud hotline poster(s).

Code of Federal Regulations, 2014 CFR

2014-10-01

... poster(s). 252.203-7004 Section 252.203-7004 Federal Acquisition Regulations System DEFENSE ACQUISITION... of Provisions And Clauses 252.203-7004 Display of fraud hotline poster(s). As prescribed in 203.1004(b)(2)(ii), use the following clause: Display of Fraud Hotline Poster(s) (DEC 2012) (a) Definition...

20 CFR 410.699a - Penalties for fraud.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Penalties for fraud. 410.699a Section 410.699a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969... Review, Finality of Decisions, and Representation of Parties § 410.699a Penalties for fraud. The penalty...

25 CFR 700.541 - Fraud or false statement in a Government matter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Fraud or false statement in a Government matter. 700.541... RELOCATION PROCEDURES Employee Responsibility and Conduct § 700.541 Fraud or false statement in a Government..., applications for employment, personnel security forms, requests for travel reimbursement, client certification...

45 CFR 235.110 - Fraud.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Fraud. 235.110 Section 235.110 Public Welfare... PROGRAMS § 235.110 Fraud. State plan requirements: A State plan under title I, IV-A, X, XIV, or XVI of the Social Security Act must provide: (a) That the State agency will establish and maintain: (1) Methods and...

42 CFR 1007.3 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... STATE MEDICAID FRAUD CONTROL UNITS § 1007.3 Scope and purpose. This part implements sections 1903(a)(6), 1903(b)(3), and 1903(q) of the Social Security Act, as amended by the Medicare-Medicaid Anti-Fraud and... costs of establishing and operating a State Medicaid fraud control unit, as defined by the statute, for...

7 CFR 762.103 - Full faith and credit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.103 Full faith and credit. (a) Fraud and... States. The Agency may contest the guarantee only in cases of fraud or misrepresentation by a lender or holder, in which: (1) The lender or holder had actual knowledge of the fraud or misrepresentation at the...

42 CFR 1001.951 - Fraud and kickbacks and other prohibited activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Fraud and kickbacks and other prohibited activities... Permissive Exclusions § 1001.951 Fraud and kickbacks and other prohibited activities. (a) Circumstance for..., or (B) Imposition of a civil money penalty against others; or (iii) Alternative sources of the type...

26 CFR 301.6110-1 - Public inspection of written determinations and background file documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... section, relating to technical advice memoranda involving civil fraud and criminal investigations, and... section 6110(d)(3) and (f)(4). (2) Technical advice memoranda involving civil fraud and criminal... § 301.6110-2(f) involving any matter that is the subject of a civil fraud or criminal investigation, a...

42 CFR 1001.951 - Fraud and kickbacks and other prohibited activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Fraud and kickbacks and other prohibited activities... Permissive Exclusions § 1001.951 Fraud and kickbacks and other prohibited activities. (a) Circumstance for..., or (B) Imposition of a civil money penalty against others; or (iii) Alternative sources of the type...

45 CFR 149.41 - Consequences of Non-Compliance, Fraud, or Similar Fault.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Consequences of Non-Compliance, Fraud, or Similar Fault. 149.41 Section 149.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS... Eligible Employment-Based Plans § 149.41 Consequences of Non-Compliance, Fraud, or Similar Fault. Upon...

45 CFR 681.5 - What happens if program fraud is suspected?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... What happens if program fraud is suspected? (a) If the investigating official concludes that an action...

45 CFR 681.5 - What happens if program fraud is suspected?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... What happens if program fraud is suspected? (a) If the investigating official concludes that an action...

45 CFR 681.5 - What happens if program fraud is suspected?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... What happens if program fraud is suspected? (a) If the investigating official concludes that an action...

45 CFR 681.5 - What happens if program fraud is suspected?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... What happens if program fraud is suspected? (a) If the investigating official concludes that an action...

76 FR 40223 - Extension of Temporary Exemptions for Eligible Credit Default Swaps To Facilitate Operation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

...-fraud provisions, as well as exempt these security-based swaps from Exchange Act registration... interest involving security-based swaps.\\31\\ We have also proposed anti-fraud and anti-manipulation rules... Against Fraud, Manipulation, and Deception in Connection with Security-Based Swaps, Release No. 34-63236...

32 CFR 516.68 - Program Fraud Civil Remedies Act (PFCRA).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Program Fraud Civil Remedies Act (PFCRA). 516.68 Section 516.68 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.68 Program...

Employee theft and fraud: bigger than ever and getting worse.

PubMed

2001-02-01

Fraud examiners and investigators say that employee theft is out of control, citing recent U.S. Chamber of Commerce figures that employees steal approximately $400 billion from businesses each year and an Ernst & Young survey showing that nearly 90% of organizations countrywide experienced some type of fraud in the 12 months prior to the survey. An additional undetermined amount is being reported lost because of external fraud committed by customers, vendors, and others having contact with a company or institution. Fraud experts interviewed for this report note that all sectors are targets--including retailers, hospitals and healthcare, the hotel industry, schools, and college campuses. In this report, we'll present the how's and whys of this development and also describe what one medical center is doing to stop thefts of medical equipment and computers.

Data fraud in clinical trials

PubMed Central

George, Stephen L; Buyse, Marc

2015-01-01

Highly publicized cases of fabrication or falsification of data in clinical trials have occurred in recent years and it is likely that there are additional undetected or unreported cases. We review the available evidence on the incidence of data fraud in clinical trials, describe several prominent cases, present information on motivation and contributing factors and discuss cost-effective ways of early detection of data fraud as part of routine central statistical monitoring of data quality. Adoption of these clinical trial monitoring procedures can identify potential data fraud not detected by conventional on-site monitoring and can improve overall data quality. PMID:25729561

The effects of loneliness on telemarketing fraud vulnerability among older adults.

PubMed

Alves, Linda M; Wilson, Steve R

2008-01-01

Older adults are disproportionately affected by telemarketing fraud, especially those who are socially isolated. Twenty-eight older adult telemarketing fraud victims completed a questionnaire assessing loneliness and other variables related to telemarketing fraud vulnerability. Victims tended to be male, divorced/separated, and college-educated, between ages of 60 and 70. Age and marital status were significantly associated with loneliness. This study is an important first step for additional research in this area and may enhance the prevention and intervention efforts of social service providers who work with older adults who may be most vulnerable.

Blood recipient unable to recover damages based on fraud.

PubMed

1995-05-05

A court ruled that [name removed] is unable to sue for fraud after acquiring HIV through a blood transfusion in 1982. [Name removed], who sued the hospital, her cardiologist, and two physicians, claimed she did not learn she had received a blood transfusion until after she was diagnosed with AIDS. She tested positive for HIV antibodies in March 1992 and was diagnosed with AIDS. The Supreme Court said a cause of action for actual fraud must be filed within six years from the date of the fraudulent act or two years from the date the plaintiff discovered the fraud.

The Role of Cognition, Personality, and Trust in Fraud Victimization in Older Adults

PubMed Central

Judges, Rebecca A.; Gallant, Sara N.; Yang, Lixia; Lee, Kang

2017-01-01

Older adults are more at risk to become a victim of consumer fraud than any other type of crime (Carcach et al., 2001) but the research on the psychological profiles of senior fraud victims is lacking. To bridge this significant gap, we surveyed 151 (120 female, 111 Caucasian) community-dwelling older adults in Southern Ontario between 60 and 90 years of age about their experiences with fraud. Participants had not been diagnosed with cognitive impairment or a neurological disorder by their doctor and looked after their own finances. We assessed their self-reported cognitive abilities using the MASQ, personality on the 60-item HEXACO Personality Inventory, and trust tendencies using a scale from the World Values Survey. There were no demographic differences between victims and non-victims. We found that victims exhibit lower levels of cognitive ability, lower honesty-humility, and lower conscientiousness than non-victims. Victims and non-victims did not differ in reported levels of interpersonal trust. Subsequent regression analyses showed that cognition is an important component in victimization over and above other social factors. The present findings suggest that fraud prevention programs should focus on improving adults’ overall cognitive functioning. Further investigation is needed to understand how age-related cognitive changes affect vulnerability to fraud and which cognitive processes are most important for preventing fraud victimization. PMID:28450847

13 CFR 142.2 - What kind of conduct will result in program fraud enforcement?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What kind of conduct will result in program fraud enforcement? 142.2 Section 142.2 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Overview and Definitions § 142.2 What kind of conduct...

Data Analytics in Procurement Fraud Prevention

DTIC Science & Technology

2014-05-30

Certified Fraud Examiners CAC common access card COR contracting officer’s representative CPAR Contractor Performance Assessment Reporting System DCAA...using analytics to predict patterns occurring in known credit card fraud investigations to prevent future schemes before they happen. The goal of...or iTunes . 4. Distributional Analytics Distributional analytics are used to detect anomalies within data. Through the use of distributional

45 CFR 30.3 - Antitrust, fraud, exception in the account of an accountable official, and interagency claims...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Antitrust, fraud, exception in the account of an accountable official, and interagency claims excluded. 30.3 Section 30.3 Public Welfare DEPARTMENT OF HEALTH... antitrust violations or fraud. (1) The standards in this part relating to compromise, suspension, and...

31 CFR 900.3 - Antitrust, fraud, and tax and interagency claims excluded.

Code of Federal Regulations, 2010 CFR

2010-07-01

... apply to tax debts. (c) Parts 900-904 of this chapter do not apply to claims between Federal agencies... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Antitrust, fraud, and tax and...) SCOPE OF STANDARDS § 900.3 Antitrust, fraud, and tax and interagency claims excluded. (a) The standards...

17 CFR 240.15c1-2 - Fraud and misrepresentation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Fraud and misrepresentation. 240.15c1-2 Section 240.15c1-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c1-2 Fraud and...

17 CFR 39.7 - Fraud in connection with the clearing of transactions on a derivatives clearing organization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Fraud in connection with the clearing of transactions on a derivatives clearing organization. 39.7 Section 39.7 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION DERIVATIVES CLEARING ORGANIZATIONS § 39.7 Fraud in connection...

43 CFR 20.510 - Fraud or false statements in a Government matter.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Fraud or false statements in a Government matter. 20.510 Section 20.510 Public Lands: Interior Office of the Secretary of the Interior EMPLOYEE RESPONSIBILITIES AND CONDUCT Other Employee Conduct Provisions § 20.510 Fraud or false statements in a Government...

43 CFR 20.510 - Fraud or false statements in a Government matter.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Fraud or false statements in a Government matter. 20.510 Section 20.510 Public Lands: Interior Office of the Secretary of the Interior EMPLOYEE RESPONSIBILITIES AND CONDUCT Other Employee Conduct Provisions § 20.510 Fraud or false statements in a Government...

Criminal Intent with Property: A Study of Real Estate Fraud Prediction and Detection

ERIC Educational Resources Information Center

Blackman, David H.

2013-01-01

The large number of real estate transactions across the United States, combined with closing process complexity, creates extremely large data sets that conceal anomalies indicative of fraud. The quantitative amount of damage due to fraud is immeasurable to the lives of individuals who are victims, not to mention the financial impact to…

78 FR 43231 - Agency Information Collection Activities: Submission to OMB for Reinstatement, Without Change, of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

...The NCUA intends to submit the following information collection to the Office of Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. Chapter 35). This information collection relates to 12 CFR part 713 which requires a federal credit union (FCU) to monitor its eligibility to qualify for a higher fidelity coverage deductible and to notify the NCUA if its financial condition changes resulting in the loss of that eligibility for the higher deductible. This information collection notice is published to obtain comments from the public. This requirement enables NCUA to monitor the FCU's financial condition for safety and soundness purposes and helps to assure that FCUs are properly and adequately protected against potential losses due to insider abuse such as fraud and embezzlement.

TANTAMOUNT TO FRAUD?: EXPLORING NON-DISCLOSURE OF GENETIC INFORMATION IN LIFE INSURANCE APPLICATIONS AS GROUNDS FOR POLICY RESCISSION.

PubMed

Prince, Anya E R

2016-01-01

Many genetic counselors recommend that individuals secure desired insurance policies, such as life insurance, prior to undergoing predictive genetic testing. It has been argued, however, that this practice is "tantamount to fraud" and that failure to disclose genetic test results, or conspiring to secure a policy before testing, opens an individual up to legal recourse. This debate traps affected individuals in a Catch-22. If they apply for life insurance and disclose a genetic test result, they may be denied. If they apply without disclosing the information, they may have committed fraud. The consequences of life insurance fraud are significant: If fraud is found on an application, a life insurer can rescind the policy, in some cases even after the individual has passed away. Such a rescission could leave family members or beneficiaries without the benefits of the life insurance policy payment after the individual's death and place them in in economic difficulty. Although it is clear that lying in response to a direct question about genetic testing would be tantamount to fraud, few, if any, life insurance applications currently include broad questions about genetic testing. This paper investigates whether non-disclosure of unasked for genetic information constitutes fraud and explores varying types of insurance questions that could conceivably be interpreted as seeking genetic information. Life insurance applicants generally have no duty to disclose unasked for information, including genetic information, on an application. However, given the complexities of genetic information, individuals may be exposed to fraud and rescission of their life insurance policy despite honest attempts to truthfully and completely answer all application questions.

Field experiment estimate of electoral fraud in Russian parliamentary elections

PubMed Central

Enikolopov, Ruben; Korovkin, Vasily; Petrova, Maria; Sonin, Konstantin; Zakharov, Alexei

2013-01-01

Electoral fraud is a widespread phenomenon, especially outside the developed world. Despite abundant qualitative and anecdotal evidence on its existence from around the world, there is very limited quantitative evidence on the extent of electoral fraud. We exploit random assignment of independent observers to 156 of 3,164 polling stations in the city of Moscow to estimate the effect of electoral fraud on the outcome of the Russian parliamentary elections held on December 4, 2011. We estimate the actual share of votes for the incumbent United Russia party to be at least 11 percentage points lower than the official count (36% instead of 47%). Our results suggest that the extent of the fraud was sufficient to have had a substantial impact on the outcome of the elections; they also confirm that the presence of observers is an important factor in ensuring the integrity of the procedure. PMID:23267093

Healthcare Fraud and Abuse

PubMed Central

Rudman, William J; Eberhardt, John S; Pierce, William; Hart-Hester, Susan

2009-01-01

In Texas, a supplier of durable medical equipment was found guilty of five counts of healthcare fraud due to submission of false claims to Medicare. The court sentenced the supplier to 120 months of incarceration and restitution of $1.6 million.1 Raritan Bay Medical Center agreed to pay the government $7.5 million to settle allegations that it defrauded the Medicare program, purposely inflating charges for inpatient and outpatient care, artificially obtaining outlier payments from Medicare.2 AmeriGroup Illinois, Inc., fraudulently skewed enrollment into the Medicaid HMO program by refusing to register pregnant women and discouraging registration for individuals with preexisting conditions. Under the False Claims Act and the Illinois Whistleblower Reward and Protection Act, AmeriGroup paid $144 million in damages to Illinois and the U.S. government and $190 million in civil penalties.3 In Florida, a dermatologist was sentenced to 22 years in prison, paid $3.7 million in restitution, forfeited an addition $3.7 million, and paid a $25,000 fine for performing 3,086 medically unnecessary surgeries on 865 Medicare beneficiaries.4 In Florida, a physician was sentenced to 24 months incarceration, ordered to pay $727,000 in restitution for cash payments where the physician signed blank prescriptions and certificates for medical necessity for patients he never saw.5 The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) found that providers in 8 out of 10 audited states received an estimated total of $27.3 million in Medicaid overpayments for services claimed after beneficiaries' deaths.6 PMID:20169019

Individual and Institutional Liability of Researchers in the Case of Scientific Fraud: Values and Ethics

ERIC Educational Resources Information Center

Baier, Eric; Dupraz, Laure

2007-01-01

How have university institutions generally tackled the fight against scientific fraud? We intend to throw light on the very process of public disclosure of scientific fraud, as it has transformed in the last 30 years within the framework of scientific research institutions. By focusing our analysis on the "denunciation process", we intend to refer…

38 CFR 1.902 - Antitrust, fraud, and tax and interagency claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

....900 through 1.953 do not apply to tax debts. (c) Sections 1.900 through 1.953 do not apply to claims... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Antitrust, fraud, and tax... Collection Effort, and Referral of Civil Claims for Money Or Property § 1.902 Antitrust, fraud, and tax and...

41 CFR 105-55.003 - Antitrust, fraud, tax, interagency claims, and claims over $100,000 excluded.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) This part does not apply to tax debts. (c) This part does not apply to claims between GSA and other... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Antitrust, fraud, tax... § 105-55.003 Antitrust, fraud, tax, interagency claims, and claims over $100,000 excluded. (a) The...

Training for Success: A Comparison of Anti-Fraud Knowledge Competencies

DTIC Science & Technology

2014-12-01

fraud, money laundering , and tax fraud. The section on punishing offenders contains two competencies: criminal prosecutions and the civil justice...investigations (Kittay, 2011). Money laundering investigations focus on the various methods individuals use to conceal proceeds earned from criminal ...Chartered Accowltants Cet·tified Anti - Money CAMS The Association of Cettified Laundering Specialist Anti - Money Latmdering Specialists Certified

17 CFR 1.1 - Fraud in or in connection with transactions in foreign currency subject to the Commodity Exchange...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Fraud in or in connection with... Securities Exchanges COMMODITY FUTURES TRADING COMMISSION GENERAL REGULATIONS UNDER THE COMMODITY EXCHANGE ACT Definitions § 1.1 Fraud in or in connection with transactions in foreign currency subject to the...

Early Detection of Online Auction Opportunistic Sellers through the Use of Negative-Positive Feedback

ERIC Educational Resources Information Center

Reinert, Gregory J.

2010-01-01

Apparently fraud is a growth industry. The monetary losses from Internet fraud have increased every year since first officially reported by the Internet Crime Complaint Center (IC3) in 2000. Prior research studies and third-party reports of fraud show rates substantially higher than eBay's reported negative feedback rate of less than 1%. The…

Health Care Fraud: Characteristics, Sanctions, and Prevention. Briefing Report to the Honorable William V. Roth, Jr., U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Accounting and Financial Management Div.

At the request of Senator William Roth, Jr., the General Accounting Office (GAO) reviewed Medicare and Medicaid fraud investigations that agency inspectors general referred to the Department of Justice for prosecution to identify characteristics of alleged fraud against the government and to determine actions taken against those caught defrauding…

Contracting Processes, Internal Controls, and Procurement Fraud: A Knowledge Assessment

DTIC Science & Technology

2015-04-30

ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Contracting Processes, Internal Controls, and Procurement Fraud: A Knowledge...DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Contracting Processes, Internal Controls, and Procurement Fraud: A Knowledge...capable processes, and effective internal controls result in the DoD having a higher level of vulnerability for procurement fraud (Rendon & Rendon, in

Protecting your practice.

PubMed

Kerr, Joseph

2015-01-01

Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations. By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice. Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Shedding light on food fraud: spectrophotometric and spectroscopic methods as a tool against economically motivated adulteration of food

NASA Astrophysics Data System (ADS)

Petronijević, R. B.; Velebit, B.; Baltić, T.

2017-09-01

Intentional modification of food or substitution of food ingredients with the aim of gaining profit is food fraud or economically motivated adulteration (EMA). EMA appeared in the food supply chain, and following the global expansion of the food market, has become a world-scale problem for the global economy. Food frauds have involved oils, milk and meat products, infant formula, honey, juices, spices, etc. New legislation was enacted in the last decade in order to fight EMA. Effective analytical methods for food fraud detection are few and still in development. The majority of the methods in common use today for EMA detection are time consuming and inappropriate for use on the production line or out of the laboratory. The next step in the evolution of analytical techniques to combat food fraud is development of fast, accurate methods applicable using portable or handheld devices. Spectrophotometric and spectroscopic methods combined with chemometric analysis, and perhaps in combination with other rapid physico-chemical techniques, could be the answer. This review discusses some analytical techniques based on spectrophotometry and spectroscopy, which are used to reveal food fraud and EMA.

From Spin to Swindle: Identifying Falsification in Financial Text.

PubMed

Minhas, Saliha; Hussain, Amir

Despite legislative attempts to curtail financial statement fraud, it continues unabated. This study makes a renewed attempt to aid in detecting this misconduct using linguistic analysis with data mining on narrative sections of annual reports/10-K form. Different from the features used in similar research, this paper extracts three distinct sets of features from a newly constructed corpus of narratives (408 annual reports/10-K, 6.5 million words) from fraud and non-fraud firms. Separately each of these three sets of features is put through a suite of classification algorithms, to determine classifier performance in this binary fraud/non-fraud discrimination task. From the results produced, there is a clear indication that the language deployed by management engaged in wilful falsification of firm performance is discernibly different from truth-tellers. For the first time, this new interdisciplinary research extracts features for readability at a much deeper level, attempts to draw out collocations using n -grams and measures tone using appropriate financial dictionaries. This linguistic analysis with machine learning-driven data mining approach to fraud detection could be used by auditors in assessing financial reporting of firms and early detection of possible misdemeanours.

Growth Hormone: Use and Abuse

MedlinePlus

... is used to treat • Growth hormone deficiency • Muscle wasting (loss of muscle tissue) from HIV • Short bowel ... and strength, with increased muscle and decreased fat mass. But other studies did not show similar benefits. ...

Risk Factors of Occupational Fraud: A Study of Member Institutions of the National Association of Independent Colleges and Universities

ERIC Educational Resources Information Center

Ten Napel, Karmen

2013-01-01

Available data indicate that colleges and universities have experienced an unexpected rise in occupational fraud over the past two decades. In order to mitigate the risk of fraud, these institutions must be proactive and have strong internal controls and policies. The purpose of this study was to examine the current controls in place at Midwest…

Fraud and Corruption Control at Education System Level: A Case Study of the Victorian Department of Education and Early Childhood Development in Australia

ERIC Educational Resources Information Center

Bandaranayake, Bandara

2014-01-01

This case describes the implementation of a fraud and corruption control policy initiative within the Victorian Department of Education and Early Childhood Development (the Department) in Australia. The policy initiative was administered and carried out by a small team of fraud control officials, including the author of this article, in the…

Misconduct accounts for the majority of retracted scientific publications

PubMed Central

Fang, Ferric C.; Steen, R. Grant; Casadevall, Arturo

2012-01-01

A detailed review of all 2,047 biomedical and life-science research articles indexed by PubMed as retracted on May 3, 2012 revealed that only 21.3% of retractions were attributable to error. In contrast, 67.4% of retractions were attributable to misconduct, including fraud or suspected fraud (43.4%), duplicate publication (14.2%), and plagiarism (9.8%). Incomplete, uninformative or misleading retraction announcements have led to a previous underestimation of the role of fraud in the ongoing retraction epidemic. The percentage of scientific articles retracted because of fraud has increased ∼10-fold since 1975. Retractions exhibit distinctive temporal and geographic patterns that may reveal underlying causes. PMID:23027971

Medicare and state health care programs: fraud and abuse, civil money penalties and intermediate sanctions for certain violations by health maintenance organizations and competitive medical plans--HHS. Final rule.

PubMed

1994-07-15

This final rule implements sections 9312(c)(2), 9312(f), and 9434(b) of Public Law 99-509, section 7 of Public Law 100-93, section 4014 of Public Law 100-203, sections 224 and 411(k)(12) of Public Law 100-360, and section 6411(d)(3) of Public Law 101-239. These provisions broaden the Secretary's authority to impose intermediate sanctions and civil money penalties on health maintenance organizations (HMOs), competitive medical plans, and other prepaid health plans contracting under Medicare or Medicaid that (1) substantially fail to provide an enrolled individual with required medically necessary items and services; (2) engage in certain marketing, enrollment, reporting, or claims payment abuses; or (3) in the case of Medicare risk-contracting plans, employ or contract with, either directly or indirectly, an individual or entity excluded from participation in Medicare. The provisions also condition Federal financial participation in certain State payments on the State's exclusion of certain prohibited entities from participation in HMO contracts and waiver programs. This final rule is intended to significantly enhance the protections for Medicare beneficiaries and Medicaid recipients enrolled in a HMO, competitive medical plan, or other contracting organization under titles XVIII and XIX of the Social Security Act.

Doctors aren't immune to theft and fraud

PubMed Central

Marcus, Gary

1995-01-01

A chartered accountant says the problem of fraud within medical practices is far from rare, even though prevention is relatively simple. Gary Marcus provides advice to physicians about ways to spot fraud within their practices and things they can do to prevent it. No matter how small your practice or how long you have had the same employees, says Marcus, given the right circumstances anyone might steal from you. Imagesp940-a PMID:7697586

Joint Contingency Contracting: Improving Through Ethics

DTIC Science & Technology

2009-05-04

sound ethical decisions. In order to avoid fraud, bribery , contractor kickbacks, or even any perception of activity that may not be in line with...avoid fraud, bribery , contractor kickbacks, or even any perception of activity that may not be in line with the proper use of U.S. Government funds, it...Efforts and Investments, released 11 Mar 2007. 1 INTRODUCTION Hardly a week goes by without a breaking news story dealing with fraud, bribery

32 CFR 516.4 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... other attorneys designated by the Chief will represent DA in all procurement fraud and corruption... procurement fraud and corruption. (o) Chief, Environmental Law Division, USALSA. The Chief, Environmental Law...

Testing the impact of local alcohol licencing policies on reported crime rates in England

PubMed Central

De Vocht, F; Heron, J; Campbell, R; Egan, M; Mooney, J D; Angus, C; Brennan, A; Hickman, M

2017-01-01

Background Excessive alcohol use contributes to public nuisance, antisocial behaviour, and domestic, interpersonal and sexual violence. We test whether licencing policies aimed at restricting its spatial and/or temporal availability, including cumulative impact zones, are associated with reductions in alcohol-related crime. Methods Reported crimes at English lower tier local authority (LTLA) level were used to calculate the rates of reported crimes including alcohol-attributable rates of sexual offences and violence against a person, and public order offences. Financial fraud was included as a control crime not directly associated with alcohol abuse. Each area was classified as to its cumulative licensing policy intensity for 2009–2015 and categorised as ‘passive’, low, medium or high. Crime rates adjusted for area deprivation, outlet density, alcohol-related hospital admissions and population size at baseline were analysed using hierarchical (log-rate) growth modelling. Results 284 of 326 LTLAs could be linked and had complete data. From 2009 to 2013 alcohol-related violent and sexual crimes and public order offences rates declined faster in areas with more ‘intense’ policies (about 1.2, 0.10 and 1.7 per 1000 people compared with 0.6, 0.01 and 1.0 per 1000 people in ‘passive’ areas, respectively). Post-2013, the recorded rates increased again. No trends were observed for financial fraud. Conclusions Local areas in England with more intense alcohol licensing policies had a stronger decline in rates of violent crimes, sexual crimes and public order offences in the period up to 2013 of the order of 4–6% greater compared with areas where these policies were not in place, but not thereafter. PMID:27514936

National Health Care Anti-Fraud Association

MedlinePlus

... a Glance Pre-Conference Programs Conference Sessions Registration Hotel & Travel Information Conference Tracks Credit Opportunities Anti-Fraud Expo Sponsors Programs Budget Adequately for 2018 Trainings NETS Webinars Launch Webinar ...

32 CFR 516.63 - Coordination with DOJ.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.63 Coordination with DOJ... significant fraud and corruption cases to accomplish the following: (1) Monitor criminal prosecutions. (2...

27 CFR 19.561 - Losses in general.

Code of Federal Regulations, 2010 CFR

2010-04-01

... appropriate TTB officer finds that the theft occurred without connivance, collusion, fraud or negligence on..., collusion, fraud, or negligence on the part of the proprietor, owner, consignor, consignee, bailee, or...

Food fraud and the perceived integrity of European food imports into China.

PubMed

Kendall, H; Naughton, P; Kuznesof, S; Raley, M; Dean, M; Clark, B; Stolz, H; Home, R; Chan, M Y; Zhong, Q; Brereton, P; Frewer, L J

2018-01-01

Persistent incidents of food fraud in China have resulted in low levels of consumer trust in the authenticity and safety of food that is domestically produced. We examined the relationship between the concerns of Chinese consumers regarding food fraud, and the role that demonstrating authenticity may play in relieving those concerns. A two-stage mixed method design research design was adopted. First, qualitative research (focus groups n = 7) was conducted in three Chinese cities, Beijing, Guangzhou and Chengdu to explore concerns held by Chinese consumers in relation to food fraud. A subsequent quantitative survey (n = 850) tested hypotheses derived from the qualitative research and theoretical literature regarding the relationship between attitudinal measures (including risk perceptions, social trust, and perceptions of benefit associated with demonstrating authenticity), and behavioral intention to purchase "authentic" European products using structural equation modelling. Chinese consumers perceive food fraud to be a hazard that represents a food safety risk. Food hazard concern was identified to be geographically influenced. Consumers in Chengdu (tier 2 city) possessed higher levels of hazard concern compared to consumers in Beijing and Guangzhou (tier 1). Structural trust (i.e. trust in actors and the governance of the food supply chain) was not a significant predictor of attitude and intention to purchase authenticated food products. Consumers were shown to have developed 'risk-relieving' strategies to compensate for the lack of trust in Chinese food and the dissonance experienced as a consequence of food fraud. Indexical and iconic authenticity cues provided by food manufacturers and regulators were important elements of product evaluations, although geographical differences in their perceived importance were observed. Targeted communication of authenticity assurance measures, including; regulations; enforcement; product testing; and actions taken by industry may improve Chinese consumer trust in the domestic food supply chain and reduce consumer concerns regarding the food safety risks associated with food fraud. To support product differentiation and retain prestige, European food manufactures operating within the Chinese market should recognise regional disparities in consumer risk perceptions regarding food fraud and the importance of personal risk mitigation strategies adopted by Chinese consumers to support the identification of authentic products.

Food fraud and the perceived integrity of European food imports into China

PubMed Central

Raley, M.; Dean, M.; Clark, B.; Stolz, H.; Home, R.; Chan, M. Y.; Zhong, Q.; Brereton, P.; Frewer, L. J.

2018-01-01

Background/Aims Persistent incidents of food fraud in China have resulted in low levels of consumer trust in the authenticity and safety of food that is domestically produced. We examined the relationship between the concerns of Chinese consumers regarding food fraud, and the role that demonstrating authenticity may play in relieving those concerns. Methods A two-stage mixed method design research design was adopted. First, qualitative research (focus groups n = 7) was conducted in three Chinese cities, Beijing, Guangzhou and Chengdu to explore concerns held by Chinese consumers in relation to food fraud. A subsequent quantitative survey (n = 850) tested hypotheses derived from the qualitative research and theoretical literature regarding the relationship between attitudinal measures (including risk perceptions, social trust, and perceptions of benefit associated with demonstrating authenticity), and behavioral intention to purchase “authentic” European products using structural equation modelling. Results Chinese consumers perceive food fraud to be a hazard that represents a food safety risk. Food hazard concern was identified to be geographically influenced. Consumers in Chengdu (tier 2 city) possessed higher levels of hazard concern compared to consumers in Beijing and Guangzhou (tier 1). Structural trust (i.e. trust in actors and the governance of the food supply chain) was not a significant predictor of attitude and intention to purchase authenticated food products. Consumers were shown to have developed ‘risk-relieving’ strategies to compensate for the lack of trust in Chinese food and the dissonance experienced as a consequence of food fraud. Indexical and iconic authenticity cues provided by food manufacturers and regulators were important elements of product evaluations, although geographical differences in their perceived importance were observed. Conclusions Targeted communication of authenticity assurance measures, including; regulations; enforcement; product testing; and actions taken by industry may improve Chinese consumer trust in the domestic food supply chain and reduce consumer concerns regarding the food safety risks associated with food fraud. To support product differentiation and retain prestige, European food manufactures operating within the Chinese market should recognise regional disparities in consumer risk perceptions regarding food fraud and the importance of personal risk mitigation strategies adopted by Chinese consumers to support the identification of authentic products. PMID:29791434

41 CFR 109-1.5108-5 - Administratively controlled items.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.51-Personal Property Management Standards and Practices § 109-1.5108-5 Administratively... help safeguard this property against waste and abuse, including purchase vs. use information, tool crib...

76 FR 42469 - Conditions of Guarantee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... be liable for payments made by USDA to any holder in the event of ``material fraud, negligence or misrepresentation by the lender or the lender's participation in or condoning of such material fraud, negligence or...

76 FR 42593 - Conditions of Guarantee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... be liable for payments made by USDA to any holder in the event of ``material fraud, negligence or misrepresentation by the lender or the lender's participation in or condoning of such material fraud, negligence or...

Podcast: Scientific Integrity and Lab Fraud

EPA Pesticide Factsheets

Nov 25, 2015. Dr. Bruce Woods, a chemist in the Electronic Crimes Division within the OIG’s Office of Investigations discusses his recent webinar for the Association of Public Health Laboratories on lab fraud.

Science ethics education part I. Perception and attitude toward scientific fraud among medical researchers.

PubMed

Vuckovic-Dekic, L; Gavrilovic, D; Kezic, I; Bogdanovic, G; Brkic, S

2011-01-01

To assess the knowledge of basic principles of responsible conduct of research and attitude toward the violations of good scientific practice among graduate biomedical students. A total of 361 subjects entered the study. The study group consisted mainly of graduate students of Medicine (85%), and other biomedical sciences (15%). Most participants were on PhD training or on postdoctoral training. A specially designed anonymous voluntary multiple-choice questionnaire was distributed to them. The questionnaire consisted of 43 questions divided in 7 parts, each aimed to assess the participants' previous knowledge and attitudes toward ethical principles of science and the main types of scientific fraud, falsification, fabrication of data, plagiarism, and false authorship. Although they considered themselves as insufficiently educated on science ethics, almost all participants recognized all types of scientific fraud, qualified these issues as highly unethical, and expressed strong negative attitude toward them. Despite that, only about half of the participants thought that superiors-violators of high ethical standards of science deserve severe punishment, and even fewer declared that they would whistle blow. These percentages were much greater in cases when the students had personally been plagiarized. Our participants recognized all types of scientific fraud as violation of ethical standards of science, expressed strong negative attitude against fraud, and believed that they would never commit fraud, thus indicating their own high moral sense. However, the unwillingness to whistle blow and to punish adequately the violators might be characterized as opportunistic behavior.

Two barriers to realizing the benefits of biometrics: a chain perspective on biometrics and identity fraud as biometrics' real challenge

NASA Astrophysics Data System (ADS)

Grijpink, Jan

2004-06-01

Along at least twelve dimensions biometric systems might vary. We need to exploit this variety to manoeuvre biometrics into place to be able to realise its social potential. Subsequently, two perspectives on biometrics are proposed revealing that biometrics will probably be ineffective in combating identity fraud, organised crime and terrorism: (1) the value chain perspective explains the first barrier: our strong preference for large scale biometric systems for general compulsory use. These biometric systems cause successful infringements to spread unnoticed. A biometric system will only function adequately if biometrics is indispensable for solving the dominant chain problem. Multi-chain use of biometrics takes it beyond the boundaries of good manageability. (2) the identity fraud perspective exposes the second barrier: our traditional approach to identity verification. We focus on identity documents, neglecting the person and the situation involved. Moreover, western legal cultures have made identity verification procedures known, transparent, uniform and predictable. Thus, we have developed a blind spot to identity fraud. Biometrics provides good potential to better checking persons, but will probably be used to enhance identity documents. Biometrics will only pay off if it confronts the identity fraudster with less predictable verification processes and more risks of his identity fraud being spotted. Standardised large scale applications of biometrics for general compulsory use without countervailing measures will probably produce the reverse. This contribution tentatively presents a few headlines for an overall biometrics strategy that could better resist identity fraud.

[Credit problems on scientific article authorships: some solutions].

PubMed

Casas-Martínez, María de la Luz

2008-01-01

Unfortunately, since the amount of publications has become a parameter for qualifying the scientific production, abuses and even frauds can take place easily. Along with the rising of new investigation projects in which numerous scientists participate, the multi-authorship has also taken place into the scientific scene, with articles having been damaged, modified or altered purposely with erroneous information and plagiarism, against the true author's will. The unconformities among the research team members reflect on a tense and stressful work atmosphere that interferes with investigation process itself; therefore, it is necessary to give and apply more transparency to these activities. The present article will analyze the recommendations from the International Committee of Medical Journal Editors on authorships for medical articles. Here it is pointed out, when an authorship should be considered as one or not, also offering possible solutions to avoid this problem, such as, the elaboration of an author's consent letters written previously to the publication of the article, the elaboration of credits and the limitation of qualified publications regarding each activity reason.

Leveraging the big-data revolution: CMS is expanding capabilities to spur health system transformation.

PubMed

Brennan, Niall; Oelschlaeger, Allison; Cox, Christine; Tavenner, Marilyn

2014-07-01

As the largest single payer for health care in the United States, the Centers for Medicare and Medicaid Services (CMS) generates enormous amounts of data. Historically, CMS has faced technological challenges in storing, analyzing, and disseminating this information because of its volume and privacy concerns. However, rapid progress in the fields of data architecture, storage, and analysis--the big-data revolution--over the past several years has given CMS the capabilities to use data in new and innovative ways. We describe the different types of CMS data being used both internally and externally, and we highlight a selection of innovative ways in which big-data techniques are being used to generate actionable information from CMS data more effectively. These include the use of real-time analytics for program monitoring and detecting fraud and abuse and the increased provision of data to providers, researchers, beneficiaries, and other stakeholders. Project HOPE—The People-to-People Health Foundation, Inc.

A prescription fraud detection model.

PubMed

Aral, Karca Duru; Güvenir, Halil Altay; Sabuncuoğlu, Ihsan; Akar, Ahmet Ruchan

2012-04-01

Prescription fraud is a main problem that causes substantial monetary loss in health care systems. We aimed to develop a model for detecting cases of prescription fraud and test it on real world data from a large multi-center medical prescription database. Conventionally, prescription fraud detection is conducted on random samples by human experts. However, the samples might be misleading and manual detection is costly. We propose a novel distance based on data-mining approach for assessing the fraudulent risk of prescriptions regarding cross-features. Final tests have been conducted on adult cardiac surgery database. The results obtained from experiments reveal that the proposed model works considerably well with a true positive rate of 77.4% and a false positive rate of 6% for the fraudulent medical prescriptions. The proposed model has the potential advantages including on-line risk prediction for prescription fraud, off-line analysis of high-risk prescriptions by human experts, and self-learning ability by regular updates of the integrative data sets. We conclude that incorporating such a system in health authorities, social security agencies and insurance companies would improve efficiency of internal review to ensure compliance with the law, and radically decrease human-expert auditing costs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

20 CFR 641.450 - Are there responsibility conditions that alone will disqualify an applicant?

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Additionally, significant fraud or criminal activity will typically include coordinated patterns or behaviors... a case-by-case basis regardless of what party identifies the alleged fraud or criminal activity. ...

GAO audit not apt to find pervasive fraud in CARE Act.

PubMed

1999-12-24

After hearing a series of news reports suggesting financial improprieties in programs run by Ryan White CARE Act recipients, a General Accounting Office (GAO) review of the program was made. A preliminary GAO report found only a few cases of fraud in the administration of funding stemming from the CARE Act, but that the potential for fraud is very real because of the lack of safeguards. These findings are considered important since the House Commerce Committee is expected to conduct oversight hearings into further authorization of the CARE Act early in 2000.

Avoiding fraud risks associated with EHRs.

PubMed

Helton, Jeffrey R

2010-07-01

Fraud associated with electronic health records (EHRs) generally falls into two categories: inappropriate billing by healthcare providers and inappropriate access by a system's users. A provider's EHR system requires controls to be of any significant help in detecting such fraudulent activity, or in gathering transactional evidence should such activity be identified. To protect against potential EHR-related healthcare fraud, providers should follow the recommendations established in 2007 by RTI International for the Office of the National Coordinator for Health Information Technology of the U.S. Department of Health and Human Services.

The jurisprudential nature of fraud in biomedical publishing.

PubMed

Candlish, John

2008-06-01

When instances of fraud in biomedical publishing come to light there is widespread indignation, not least because the consequences seem usually only to be internal enquiries and professional displeasure. A number of bodies have been constituted to improve publishing ethics and but these are largely advisory. Potentially though, actions in the tort of deceit and negligence, possibly misfeasance in a public office, and loss of chance could be brought against those responsible. These aspects are examined in the context of English law. In addition the new Fraud Act (2006) appears to be wide enough in scope to cover publishing fraud as a criminal offence. Any organisation such as a drug company financing clinical trials which produce spurious results could face serious losses and might well look to remedies in contract as well as in tort. A theoretical scenario centered on a drug trial is presented in order to explore these issues.

Economic violence to women and girls: is it receiving the necessary attention?

PubMed

Fawole, Olufunmilayo I

2008-07-01

Most studies on gender-based violence (GBV) have focused on its physical, sexual, and psychological manifestations. This paper seeks to draw attention to the types of economic violence experienced by women, and describes its consequences on health and development. Economic violence experienced included limited access to funds and credit; controlling access to health care, employment, education, including agricultural resources; excluding from financial decision making; and discriminatory traditional laws on inheritance, property rights, and use of communal land. At work women experienced receiving unequal remuneration for work done equal in value to the men's, were overworked and underpaid, and used for unpaid work outside the contractual agreement. Some experienced fraud and theft from some men, illegal confiscation of goods for sale, and unlawful closing down of worksites. At home, some were barred from working by partners; while other men totally abandoned family maintenance to the women. Unfortunately, economic violence results in deepening poverty and compromises educational attainment and developmental opportunities for women. It leads to physical violence, promotes sexual exploitation and the risk of contracting HIV infection, maternal morbidity and mortality, and trafficking of women and girls. Economic abuse may continue even after the woman has left the abusive relationship. There is need for further large-scale studies on economic violence to women. Multi-strategy interventions that promote equity between women and men, provide economic opportunities for women, inform them of their rights, reach out to men and change societal beliefs and attitudes that permit exploitative behavior are urgently required.

A real time metabolomic profiling approach to detecting fish fraud using rapid evaporative ionisation mass spectrometry.

PubMed

Black, Connor; Chevallier, Olivier P; Haughey, Simon A; Balog, Julia; Stead, Sara; Pringle, Steven D; Riina, Maria V; Martucci, Francesca; Acutis, Pier L; Morris, Mike; Nikolopoulos, Dimitrios S; Takats, Zoltan; Elliott, Christopher T

2017-01-01

Fish fraud detection is mainly carried out using a genomic profiling approach requiring long and complex sample preparations and assay running times. Rapid evaporative ionisation mass spectrometry (REIMS) can circumvent these issues without sacrificing a loss in the quality of results. To demonstrate that REIMS can be used as a fast profiling technique capable of achieving accurate species identification without the need for any sample preparation. Additionally, we wanted to demonstrate that other aspects of fish fraud other than speciation are detectable using REIMS. 478 samples of five different white fish species were subjected to REIMS analysis using an electrosurgical knife. Each sample was cut 8-12 times with each one lasting 3-5 s and chemometric models were generated based on the mass range m/z 600-950 of each sample. The identification of 99 validation samples provided a 98.99% correct classification in which species identification was obtained near-instantaneously (≈ 2 s) unlike any other form of food fraud analysis. Significant time comparisons between REIMS and polymerase chain reaction (PCR) were observed when analysing 6 mislabelled samples demonstrating how REIMS can be used as a complimentary technique to detect fish fraud. Additionally, we have demonstrated that the catch method of fish products is capable of detection using REIMS, a concept never previously reported. REIMS has been proven to be an innovative technique to help aid the detection of fish fraud and has the potential to be utilised by fisheries to conduct their own quality control (QC) checks for fast accurate results.

42 CFR 455.14 - Preliminary investigation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud Detection and Investigation Program § 455.14 Preliminary investigation. If the agency receives a complaint of Medicaid fraud...

38 CFR 3.901 - Fraud.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Compensation, and Dependency and Indemnity Compensation Forfeiture § 3.901 Fraud. (a) Definition. An act... death benefit payable. (2) Amount of compensation payable but for the forfeiture. No benefits are... affidavit, declaration, certificate, statement, voucher, or paper, concerning any claim for benefits under...

76 FR 49522 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Amending...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... company. \\5\\ 15 U.S.C. 77a. Significant regulatory concerns, including accounting fraud allegations, have... listed company) is not engaged in undetected accounting fraud or subject to other concealed and...

Fraud and Australian Academics.

ERIC Educational Resources Information Center

Martin, Brian

1989-01-01

A series of highly publicized cases of alleged fraud in the Australian academic community are described. Each case reveals an apparent failure of peer review. The right to pursue investigations and make comments that may offend powerful figures within the scholarly community is precarious. (MLW)

School Dropouts, Absenteeism, and Tardiness.

ERIC Educational Resources Information Center

Ediger, Marlow

When students are tardy or absent, or when they drop out of school, sequential learning cannot occur, subject matter and skills cannot be developed, and much student talent is wasted. At-risk students identified in the school setting include those exhibiting signs of alcohol consumption, drug abuse, or antisocial behavior. These students need…

77 FR 39781 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing of Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... would be for an IPO. \\3\\ 15 U.S.C. 77a. Significant regulatory concerns, including accounting fraud... accounting fraud or subject to other concealed and undisclosed legal or regulatory problems. For purposes of...

12 CFR 1731.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND SOUNDNESS MORTGAGE FRAUD REPORTING § 1731.2 Definitions. For purposes of this part— (a) Director... Association or the Federal Home Loan Mortgage Corporation. (c) Mortgage fraud means a material misstatement... mortgage, including a mortgage associated with a mortgage-backed security or similar financial instrument...

An Analysis of Fraud on the Internet.

ERIC Educational Resources Information Center

Baker, C. Richard

1999-01-01

Examines the issue of fraud on the Internet and discusses three areas with significant potential for misleading and fraudulent practices: securities sales and trading; electronic commerce, including privacy and information protection; and the rapid growth of Internet companies, including advertising issues. (Author/LRW)

28 CFR 68.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... IMMIGRATION-RELATED EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.2 Definitions. For purposes of this part: Adjudicatory proceeding means an administrative judicial-type proceeding, before the Office of the Chief... law by an Administrative Law Judge or the Chief Administrative Hearing Officer; Document fraud cases...

28 CFR 68.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IMMIGRATION-RELATED EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.2 Definitions. For purposes of this part: Adjudicatory proceeding means an administrative judicial-type proceeding, before the Office of the Chief... law by an Administrative Law Judge or the Chief Administrative Hearing Officer; Document fraud cases...

Odometer Fraud: Traffic Safety Tips

DOT National Transportation Integrated Search

1996-01-01

This fact sheet, NHTSA Facts: Summer 1996, focuses on odometer fraud, which is a major problem for consumers. Some late model used cars have odometers that have been turned back. Any vehicle that has been driven a high number of miles but is only a f...

A holistic approach to food safety risks: Food fraud as an example.

PubMed

Marvin, Hans J P; Bouzembrak, Yamine; Janssen, Esmée M; van der Fels-Klerx, H J; van Asselt, Esther D; Kleter, Gijs A

2016-11-01

Production of sufficient, safe and nutritious food is a global challenge faced by the actors operating in the food production chain. The performance of food-producing systems from farm to fork is directly and indirectly influenced by major changes in, for example, climate, demographics, and the economy. Many of these major trends will also drive the development of food safety risks and thus will have an effect on human health, local societies and economies. It is advocated that a holistic or system approach taking into account the influence of multiple "drivers" on food safety is followed to predict the increased likelihood of occurrence of safety incidents so as to be better prepared to prevent, mitigate and manage associated risks. The value of using a Bayesian Network (BN) modelling approach for this purpose is demonstrated in this paper using food fraud as an example. Possible links between food fraud cases retrieved from the RASFF (EU) and EMA (USA) databases and features of these cases provided by both the records themselves and additional data obtained from other sources are demonstrated. The BN model was developed from 1393 food fraud cases and 15 different data sources. With this model applied to these collected data on food fraud cases, the product categories that thus showed the highest probabilities of being fraudulent were "fish and seafood" (20.6%), "meat" (13.4%) and "fruits and vegetables" (10.4%). Features of the country of origin appeared to be important factors in identifying the possible hazards associated with a product. The model had a predictive accuracy of 91.5% for the fraud type and demonstrates how expert knowledge and data can be combined within a model to assist risk managers to better understand the factors and their interrelationships. Copyright © 2016 Elsevier Ltd. All rights reserved.

Equal Potential: A Collective Fraud.

ERIC Educational Resources Information Center

Gottfredson, Linda S.

2000-01-01

Critiques the College Board's report, "Reaching the Top," asserting that it illustrates collective fraud in the social sciences, which sustains an egalitarian fiction that intelligence is clustered equally across all human populations. Suggests that while the report omits certain popular falsehoods, it also omits crucial truths about…

7 CFR 1.302 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Under the Program Fraud Civil Remedies Act of 1986 § 1.302 Definitions. (a) Agency means a constituent organizational unit of the USDA. (b) Agency Fraud Claims Officer—(AFCO) means an officer or employee of an agency...) Statement means any representation, certification, affirmation, document, record, or accounting or...

Looking at Debit and Credit Card Fraud

ERIC Educational Resources Information Center

Porkess, Roger; Mason, Stephen

2012-01-01

This article, written jointly by a mathematician and a barrister, looks at some of the statistical issues raised by court cases based on fraud involving chip and PIN cards. It provides examples and insights that statistics teachers should find helpful. (Contains 4 tables and 1 figure.)

8 CFR 270.2 - Enforcement procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS PENALTIES FOR DOCUMENT FRAUD § 270.2 Enforcement procedures. (a) Procedures for the filing of complaints. Any person or entity... charges for document fraud committed by refugees at the time of entry. The Service shall not issue a...

Lock Up Those Lines: Protecting against Phone Fraud.

ERIC Educational Resources Information Center

Schleyer, Peggy E.; Hibner, Dale V.

1996-01-01

School business officials must be aware of potential liabilities associated with Centrex and Private Branch Exchange (PBX). This article describes these systems, presents guidelines for developing a telecommunications management plan, and discusses options to limit toll fraud exposure. PBX owners should implement manufacturers' recommended…

76 FR 80901 - Agency Information Collection Activities Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... monitoring legal proceedings involving the responsibilities imposed on contract markets and their officials... avoid fraud and misrepresentations. In addition, the Commission's rules impose obligations on contract markets that are designed to avoid manipulation and fraud. In order to ensure compliance with these rules...

20 CFR 625.14 - Overpayments; disqualification for fraud.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DISASTER UNEMPLOYMENT ASSISTANCE § 625.14 Overpayments; disqualification for fraud. (a) Finding and... unemployment compensation law administered by the State agency, or from any assistance or allowance payable to the individual with respect to unemployment under any other Federal law administered by the State...

20 CFR 625.14 - Overpayments; disqualification for fraud.

Code of Federal Regulations, 2012 CFR

2012-04-01

... DISASTER UNEMPLOYMENT ASSISTANCE § 625.14 Overpayments; disqualification for fraud. (a) Finding and... unemployment compensation law administered by the State agency, or from any assistance or allowance payable to the individual with respect to unemployment under any other Federal law administered by the State...

20 CFR 625.14 - Overpayments; disqualification for fraud.

Code of Federal Regulations, 2014 CFR

2014-04-01

... DISASTER UNEMPLOYMENT ASSISTANCE § 625.14 Overpayments; disqualification for fraud. (a) Finding and... unemployment compensation law administered by the State agency, or from any assistance or allowance payable to the individual with respect to unemployment under any other Federal law administered by the State...

20 CFR 625.14 - Overpayments; disqualification for fraud.

Code of Federal Regulations, 2011 CFR

2011-04-01

... DISASTER UNEMPLOYMENT ASSISTANCE § 625.14 Overpayments; disqualification for fraud. (a) Finding and... unemployment compensation law administered by the State agency, or from any assistance or allowance payable to the individual with respect to unemployment under any other Federal law administered by the State...

20 CFR 625.14 - Overpayments; disqualification for fraud.

Code of Federal Regulations, 2013 CFR

2013-04-01

... DISASTER UNEMPLOYMENT ASSISTANCE § 625.14 Overpayments; disqualification for fraud. (a) Finding and... unemployment compensation law administered by the State agency, or from any assistance or allowance payable to the individual with respect to unemployment under any other Federal law administered by the State...

An appraisal of the performance of the economic and financial crimes commission in Nigeria.

PubMed

Sowunmi, Fatai Abiola; Adesola, Muniru Adekunle; Salako, Mudashiru Abiodun

2010-12-01

This article examines how an anti-graft body, the Economic and Financial Crime Commission (EFCC), has fared in reducing the incidence of corruption in Nigeria, in particular, bank fraud, Internet scam, and bad governance. It first discusses the corruption situation in Nigeria by highlighting public office holders who have been associated with corruption charges. A Likert-type scale is used in designing the questionnaire for data collection. Descriptive and chi-square analyses are used, and results reveal that the performance of the EFCC has been affected by government interference (p < .05). However, although the anti-graft body has not been able to reduce the incidence of bank fraud (p > .05), bad governance and advance fee fraud have recorded appreciable reduction (p < .05). Areas of success as well as challenges that need to be addressed are identified. Specifically, it is recommended that the bill that established EFCC should be amended to reduce government interference and improve its manpower development, especially in the areas of fraud and Internet scam detection.

An inequality for detecting financial fraud, derived from the Markowitz Optimal Portfolio Theory

NASA Astrophysics Data System (ADS)

Bard, Gregory V.

2016-12-01

The Markowitz Optimal Portfolio Theory, published in 1952, is well-known, and was often taught because it blends Lagrange Multipliers, matrices, statistics, and mathematical finance. However, the theory faded from prominence in American investing, as Business departments at US universities shifted from techniques based on mathematics, finance, and statistics, to focus instead on leadership, public speaking, interpersonal skills, advertising, etc… The author proposes a new application of Markowitz's Theory: the detection of a fairly broad category of financial fraud (called "Ponzi schemes" in American newspapers) by looking at a particular inequality derived from the Markowitz Optimal Portfolio Theory, relating volatility and expected rate of return. For example, one recent Ponzi scheme was that of Bernard Madoff, uncovered in December 2008, which comprised fraud totaling 64,800,000,000 US dollars [23]. The objective is to compare investments with the "efficient frontier" as predicted by Markowitz's theory. Violations of the inequality should be impossible in theory; therefore, in practice, violations might indicate fraud.

Document fraud deterrent strategies: four case studies

NASA Astrophysics Data System (ADS)

Mercer, John W.

1998-04-01

This paper discusses the approaches taken to deter fraud committed against four documents: the machine-readable passport; the machine-readable visa; the Consular Report of Birth Abroad; and the Border Crossing Card. General approaches are discussed first, with an emphasis on the reasons for the document, the conditions of its use and the information systems required for it to function. A cost model of counterfeit deterrence is introduced. Specific approaches to each of the four documents are then discussed, in light of the issuance circumstances and criteria, the intent of the issuing authority, the applicable international standards and the level of protection and fraud resistance appropriate for the document.

[Nutritional status in children victims of physical and sexual abuse].

PubMed

Martín-Martín, Verónica; Loredo-Abdalá, Arturo

2010-01-01

To assess and relate the nutritional status by type of abuse in a pediatric population diagnosed with physical abuse (PA) and sexual abuse (SA). It's a retrospective, cross-sectional, descriptive study of 178 clinical records of children aged less than 12 years, attended at the Clinic for the Integral Care of the Abused Child of the Instituto Nacional de Pediatría and the Universidad Nacional Autónoma de México (CAINM-INP-UNAM), during the period 1994 to 2005. The relationship of nutritional status with the type of abuse was analyzed in two age ranges (3 months to less than five years, and five to 11 years) and gender with Student t and chi-square tests. We identified that, in girls PA was associated with stunting (PA: 48% vs. SA: 12%, p < 0.005 and PA: 21% vs. SA: 0%, p < 0.002) and wasting (PA: 21% vs. SA: 0%, p < 0.01 and PA: 21% vs. SA: 0%, p < 0.002). Whereas in girls SA was associated with overweight and obesity in age range five to 11 years (PA: 0% vs. SA: 31%; p < 0.01). This study identified acute and chronic under nutrition in girls with PA, and overweight and obesity in girls with SA. These findings enrich the knowledge for the suspicion of maltreatment child syndrome during the search of the aetiology of the clinical expression studied.

32 CFR 516.58 - Policies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Policies. 516.58 Section 516.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.58 Policies. (a) Procurement fraud and...

7 CFR 1773.9 - Disclosure of fraud, illegal acts, and other noncompliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., the auditor must design the audit to provide reasonable assurance of detecting fraud that is material... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit... statements, auditors should apply audit procedures specifically directed to ascertaining whether an illegal...

78 FR 79567 - Supplemental Nutrition Assistance Program: Trafficking Controls and Fraud Investigations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service 7 CFR Parts 271 and 274 RIN 0584-AE26 Supplemental Nutrition Assistance Program: Trafficking Controls and Fraud Investigations AGENCY: Food and Nutrition Service, USDA. ACTION: Final rule, Interim final rule; notice of approval of Information...

Academic Misconduct in Teaching Portfolios

ERIC Educational Resources Information Center

Erikson, Martin G.; Erlandson, Peter; Erikson, Malgorzata

2015-01-01

Within academia, clear and standardised communication is vital. From this point of departure, we discuss the trustworthiness of teaching portfolios when used in assessment. Here, misconduct and fraud are discussed in terms of fabrication, falsification, and plagiarism, following the literature on research fraud. We argue that the portfolio's…

12 CFR 1731.3 - Unsafe and unsound conduct.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEVELOPMENT SAFETY AND SOUNDNESS MORTGAGE FRAUD REPORTING § 1731.3 Unsafe and unsound conduct. An Enterprise may not require the repurchase of or may not decline to purchase a mortgage, mortgage backed security, or similar financial instrument because of possible mortgage fraud without promptly reporting to the...

16 CFR 660.4 - Direct disputes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... direct disputes relating to whether there is or has been identity theft or fraud against the consumer... direct disputes relating to the type of account, principal balance, scheduled payment amount on an... relationship with the consumer); (v) Information related to fraud alerts or active duty alerts; or (vi...

12 CFR 222.43 - Direct disputes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fraud against the consumer, whether there is individual or joint liability on an account, or whether the... the furnisher, such as direct disputes relating to the type of account, principal balance, scheduled... relationship with the consumer); (v) Information related to fraud alerts or active duty alerts; or (vi...

12 CFR 334.43 - Direct disputes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... furnisher, such as direct disputes relating to whether there is or has been identity theft or fraud against... furnisher, such as direct disputes relating to the type of account, principal balance, scheduled payment... relationship with the consumer); (v) Information related to fraud alerts or active duty alerts; or (vi...