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Industry-Specific Fraud / Insurance Fraud

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Avoiding the pitfalls of protected health information and fraud This article is for ACFE members only
Health care fraud is big business, and in more ways than just claims fraud. Protected health information (PHI) is subject to fraud and abuse. And, most people don't realize that the health benefit card is like a credit card vulnerable to thieves who steal it and use it for unlawful gain. Learn how current technology can be used for tracking how PHI is being abused and what you can do to prevent it.

Baiting the Rat Trap: Recorded statements and 'EUOs' This article is for ACFE members only
You can learn how to bait a trap to catch insurance offenders before they claim more money. And the interview skills you'll acquire will help in all other types of fraud examinations.*

Blood Money: Lab Case Highlights Nationwide Medicaid Fraud Units This article is for ACFE members only
Mohammad Akthat Javid thought he had the perfect scam: he would magically transform red blood into green cash.

Catching the Little Fish that Got Away This article is for ACFE members only
Protect yourself against small-time frauds by insured subscribers.

‘Damaged’ Fingers? Minimized Employee Accident Report Forms Lead to $600,000 in Fines and Penalties This article is for ACFE members only
Investigators found that the company had intentionally downplayed a number of serious injuries, which resulted in the company receiving hundreds of thousands of dollars in government rebate money.

Insidious Mold Fraud This article is for ACFE members only
Mold has existed before humans and will probably outlast us but recent huge mold insurance claims have inspired fraudsters to make some quick money.

Healthcare and insurance fraud: International piracy losses in the insurance industry This article is for ACFE members only
The International Maritime Bureau runs the Piracy Reporting Centre which provides the most comprehensive information on piracy worldwide. In today’s world of instant communications and geographical positioning systems (GPS) how can this ancient crime continue to thrive? This session examines the types of attacks, the numbers, and world hotspots using examples of real cases. It will conclude with measures being taken against piracy and thoughts on the way ahead.

Living Longer, Dying Slower: Long-term Care Insurance Fraud This article is for ACFE members only
All fraud examiners must know about this impending assault on both the global health care sector and the public’s financial reserves.

The World’s Dumbest Fraudsters
I've searched high and low to bring you examples of the dumbest of the dumbsters. And I admit it up front: The only lesson to be learned is just how stupid some people can be.

This article is for ACFE members only. Click here for information about membership.

The Association of Certified Fraud Examiners assumes sole copyright of any article published in Fraud Magazine. Fraud Magazine follows a policy of exclusive publication. Permission of the publisher is required before an article can be copied or reproduced. Requests for reprinting an article in any form must be e-mailed to: FraudMagazine@ACFE.com.

 


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