||CPE Credits: 2
Course Level: Advanced
It is estimated that $24 million per hour goes to fraud waste and abuse. Where does the money go? On October 23, 2008, in Portland, Maine, Steven P. Amato, formerly of Bremen, Maine, was sentenced to 24 months in prison. On October 15, 2008, in Newark, New Jersey, Boris Sokha was sentenced to 47 months in prison and ordered to pay $2.5 million in restitution and a $10,000 fine for defrauding insurance companies. The 2005 Federal Trade Commission reported an astounding 260,000 victims of medical identity theft. In July 2007, nine men were accused of an international prescription drug counterfeit ring. These examples could go on and on.
This course will examine an overview of the worldwide health care fraud epidemic and how the global economy is inviting organized efforts into the health care arena. Pharmaceutical activity and medical identity theft are high on the list of activities perpetrated by the ethically challenged. Within the United States, the OIG is mandating compliance programs that require effective data mining analytics and appropriate tools to process large amounts of data. The advanced component of this session will include a discussion of critical components required to effectively mine data for fraud in this complex, high-dollar industry. The concepts will be applied to actual cases on a variety of subject matter including those cases cited in the summary.
What you will learn:
Awareness of the globalization of health care fraud
New emerging schemes
Data mining tools required for detection
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Presenter: Rebecca S. Busch, CFE
Recording Date: May 21, 2009
Duration: 100 Minutes
field of study: Specialized Knowledge and Applications
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Online CPE exam grading available for this course:
Online grading is available for ACFE self-study workbook courses. Complete the course offline at your convenience, but take the exam online the moment you're ready. Featuring instant exam results and a printable certificate, online grading offers a quick and convenient way to earn CPE.
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Please note: All self-study course exams must be completed within one year of purchase date to receive CPE credit.
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