Kathleen Sibelius announced “nationwide takedown” by Medicare Fraud Strike Force operations‚ in eight cities that resulted in charges against 89 individuals‚ which included doctors‚ nurses and other licensed medical professionals‚ for their alleged participation in Medicare fraud schemes involving approximately $223 million in false billings. In Chicago‚ seven individuals were charged‚ including two doctors‚ with a variety of health care fraud schemes. This (sixth) nationwide takedown targeted eight cities:
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1. Identify the fraud risk factors at Peregrine‚ especially control environment factors and the tone at the top‚ using the fraud triangle. The fraud risk factors could be identified as incentives/pressures‚ opportunities‚ and attitudes/rationalization in fraud triangle. According to the case‚ Peregrine’ control environment had an essential issue on separation of duties. In PFG‚ only Russell Wasendorf could open the real bank balance‚ which gave the opportunity to Wasendorf. Peregrine was suffer from
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Coding Fraud Michael Anastasio Ultimate Medical Academy Before answering the questions “what are my responsibilities for billing on a procedure that was not performed but asked to do so anyway”‚ Let me explain a little on Medical Billing Fraud? It is an attempt to fraudulently obtain payments from insurance carriers. Fraud in medical billing cost tax payers and medical providers millions of dollars annually (all-things-medical-billing.com). In 1996‚ HIPPA established the Health Care Fraud and
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Business Law Case Study In the case presented‚ Biff Smith‚ the Chief of Police of the local department ordered a set of bicycles off of a local storeowner‚ Dirk Right. This was no simple order though‚ in fact Biff intended on starting a bike patrol unit within the local department. Biff went to Dirks Bicycle shop to place an order. The order was for five mountain bikes to be used for patrol so they had to be custom made in order to sport the police decals. Biff was very familiar with the Schwinn
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Intrapreneurship Case Study of the Sony Corporation‚ according to Ken Kutaragi PlayStation Intrapreneur The story of the Intrapreneurial (corporate entrepreneurial) corporate struggles‚ determination and the ultimate creation of the very successful Sony PlayStation by persistent and driven intrapreneur Ken Kutaragi‚ who’s international Intrapreneurial Success story has now become one of the most celebrated in business history. Intrapreneurship has been successfully utilized by corporations‚ partnerships
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Case Jonathan‚ a moneylender makes a loan of $1‚000 to Sheba on Sheba’s representation that she is 19 years old. Sheba is in fact 17 years old. She enrolled for diploma course with a private college for $500‚ spent $200 on a holiday‚ and the balance of $300 on a mini hi-fi set. She now refuses to pay Jonathan. In this case‚ we are acting for Jonathan (plaintiff). Jonathan sues Sheba (defendant) because of free consent and capacity. Free consent that we talk is about misrepresentation whereas capacity
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local charity‚ and creating jobs. But in reality‚ “he was a con man who built a building on smoke and mirrors”. Russell Wasendorf‚ Sr. sentenced on variety of factors‚ such as financial loss‚ sophistically executed the fraud‚ and stole money of large number of victims and so on. The fraud was started in early 1990’s‚ when Wasendorf partner of Peregrine
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MODULE 3: CIT CASE QUESTIONS 1. The three aspects of fraud - Perceived pressure‚ Rationalization‚ and Opportunity were present in the CIT case as follows: Pressure- Niakan was placed under much pressure to meet monthly targets. The senior VP Ms. Thompson had earlier criticized his performance when it fell below expectations. Niakan had also been warned in his 2002 annual review that his team needed to improve end of lease sales and inventory returns. Apart from this work angle Niakan had personal
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Question 1: Name two cases in which companies have committed frauds by misstating inventory. Crazy Eddie and Goodner Brothers case are the good example for the inventory fraud cases. Question 2: What makes the intentional misstatement of inventory difficult to detect? When you have the most senior management of the company‚ particularly its financial management‚ consciously setting out to fool the auditors‚ to hide information from them‚ as they testified in the Monus trial‚ it’s very hard to
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Insurance Fraud A gang of Russian crooks ran a record-setting‚ $279 million fraud that exploited New York’s “no-fault” auto –accident law‚ authorities said 2/29/12. The gang worked with corrupt doctors to set up more than 100 phony medical clinics across the city. There‚ they generated fake bills for the treatment of “injuries” that “ranged from wild exaggerations to outright fabrications‚” Manhattan US Attorney Preet Bharara said. The fraudsters took advantage of the “patient-friendly provisions”
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