TADA Fraud Hotline

SOCS10261G Scams Frauds Identity Theft Crimes of Deception in the Information Age - Term 1129, Class 75036

Federal or state authorities may investigate allegations of fraud depending on where the fraud was reported, the laws broken, and the amount of money involved. The strictness of penalties levied by state governments varies from state to state. Federal laws such as The False Claims Act, Anti-Kickback Statute, and Social Security Act are laws that address fraud and abuse. Title XI of the Social Security Act contains Medicaid program-related anti-fraud provisions, which impose civil penalties, criminal penalties, and exclusions from federal health care programs on persons who engage in certain types of misconduct (Staman, 2010). Under federal regulations, providers convicted of fraud are excluded for a minimum of five years from receiving funds from any federally

Fraud is a serious crime that should concern all parties of the U.S. health care system and is a costly reality that the government cannot overlook. While not all fraud can be prevented, by learning about the many different types of fraud, patients can be educated on how to protect themselves from fraud. If we use government programs to inform the public that they can be targeted, the dollar amount for these cases for fraud can be reduced. An informed public and a properly funded FBI will go a long ways in the overall crackdown of health care fraud.

I obtained the data for this report by scouring the internet for stories and data that backed up my claim that the fraud is committed mostly between individuals and conducted a survey at a large retail store that asked the following questions:

After the preliminary information surrounding the need of the program is assessed, the most helpful information would be to find out how many cases of fraud there is in a given year. Knowing how relevant the problem is that exists would be a great place to start in finding a solution. Additionally, for the controversial solutions that have been introduced, such as the fingerprinting methods, more substantial data needs to be analyzed to determine the success of the program.

“The National Incident-Based Reporting System (NIBRS) represents a redesign of the FBI’s summary crime reporting system, the Uniform Crime Reporting (UCR) program.”(Levitt, 1998). It is an incident-based reporting system in which agencies collect qualitative and quantitative data on each single crime that is committed and arrest that is made. Data that is reported to the NIBRS can come from various sources such as local, state, and federal automated records systems. It was established in late 1970s due to a large part of law enforcement agencies continuing to express growing dissatisfaction with the narrow scope of information detailed in the UCR.

The three sources for crime data in the United States are known as the Uniform crime report, the National incident based reporting system, and the National Crime Victimization Survey. The Uniform Crime report is a nationwide data system with data from over eighteen-thousand-two hundred and ninety jurisdictions that puts date into a rate of crime per area format. The data comes from cities, counties, states, tribal universities, college and federal law agencies. The data is compiled by law enforcement. The main problem with

One such method is organizational data gathering which rather than assembling statistical data it aims to collect profiling information to increase the chance of arrest therefore providing more data (Hayes and Prenzler, 2008). In 2003-4 the Australian Competition and Consumer Commission (ACCC) received a total of 63,695 complaints and enquiries and of that amount 480 were investigated of which 22 were taken to court. Overall in 2003-4 police investigated only 0.7% of possible white-collar crimes (ACCC, 2004). As technology increases so does the complexity of white-collar crime therefore facilitating for a predicted rise in frequency. White-collar crime is the highest costing of all crimes and damages people both directly and indirectly through economic manipulation.

“Financial crimes enforcement network (FinCEN) is a bureau of the treasury department and the financial intelligence unit of the United States of America”. FinCEN’s typically involved in the process of solving the financial crimes. FinCEN’s faced data and IT problems to control the financial corruption. Incompatible or unpredictable and unstandardized i.e. data errors, financial data were lessen the strength of FinCEN’s. Because of these data chaos FinCEN’s evaluates the financial organizations or company’s data with small data firm and normal patterns. The authority cannot put up across higher data sets and minus effectiveness for dedicated analysis and tendency prediction. Broadcasting the data to companies through various offline systems

It is said that tip lines are some of the most effective tools that any organization can possess for detecting and discovering fraud. Because tip lines are solely anonymous, it has recently become an inexpensive way to successfully report fraud. The article “Fraud Hotlines: Don’t Miss That Call,” is a perfect example of characteristic descriptions that show different levels of service and cost that is provided by the best tip line providers.

In this day and age, a corporation, family, or individual always has a potential risk of encountering fraud within their money supply. On average, fraud and abuse costs U.S. organizations more than $400 billion annually (Federal Bureau Investigation, 2010). Many may think that white collared crime is only money laundering or stealing, but that is only two out of the sum that countless culprits get away with. The term “white-collar crime,” originally coined in 1939 is synonymous with the full range of frauds committed by business and government professionals (Federal Bureau Investigation, 2010). These frauds include anything from bankruptcy fraud, money laundering, identity theft, corporate fraud to a wide number of threats all circling

According to Daniel F. Dooley (2008), a member of the Commercial Fraud Taskforce, financial fraud with private middle-market companies is on the rise. In fact, Mr. Dooley believes that he has seen more instances of fraud in the past two years than in the previous ten. He notes seven areas in which financial fraud has increased over the past few years:

The previous organizational structure for payment of services rendered did not allow officials enough time to investigate claims to ensure the claims were legitimate. Perpetrators study the law and use the knowledge to fraud insurance and government agencies. The governance of rules, regulations and laws was not stringent enough to stop perpetrators from frauding the system. New guidelines allow agencies more time to detect suspicious claims, investigate and save the insurance companies millions of dollars. Society does not concentrate on proactive actions to prevent fraud, instead society deals with the problem after the fact. Consumer watch groups do not have tools in place to prevent fraud. Perpetrators rely on the oversites of insurance companies in order to target and fraud insurance companies.

White collar crime is a serious issue in the United States. White-collar crime is “a crime committed by a person of respectability and high social status in the course of his occupation” (cornell.edu). Examples of such offenses include bribery, credit card fraud, insurance fraud, bank fraud, blackmail, extortion, forgery, securities fraud, tax evasion, embezzlement, repair scams, Ponzi and pyramid schemes. These non-violent crimes are responsible for an estimated $250 billion to $1 trillion in economic damages each year (Martinez). Individuals who commit white collar crimes have an increased likelihood to experience injustice compared to those who commit a street crime as noted in multiple studies detailed in various scholarly articles. Also, street criminals have a greater chance of getting caught in their wrongdoings versus white-collar criminals. Those who commit white collar crime make their decisions based on the philosophy or idea that their actions have low risk and a high reward. We face a dilemma in the United States because white-collar criminals are treated with minimal, inequitable punishment due to their social status, whereas the street criminals are treated with the correct, impartial punishment.

In 2007 the New York times reported 12 that infoUSA, a data brokering company, sold lists about old vulnerable people (such as “old people looking for ways to make money” or “suffering seniors dealing with cancer or Alzheimer’s”) which are more likely to be naive and/or credulous, and the purchasers used those lists for fraudulent purposes. For example a 92 years old man was duped into revealing his banking data to