Methodology of Economic Crimes week 9 individual
Week 9: Week Nine - Individual Work
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(In your own words, referencing)
|Only 150 words |
|Instructional Objectives for this activity: |
Summarize the characteristics of elder economic abuse.
|After reviewing the elements and nature of embezzlement and public services fraud, please answer the following prompts in this week's paper.|
This paper should be approximately 300words in length. Be sure to use proper APA format in your citations of material from all sources
- List and discuss the basic elements of embezzlement.
- List and discuss the basic elements of public services fraud.
- How do both types of fraud involve an element of breach of trust?
- In your textbook Economic Crimes, Criminal Investigation Series:
- Review the following portion of Chapter 9, "Embezzlement" on pages XXXXXXXXXX.
- Review the following portions of Chapter 10, "Public Services Fraud" on pages XXXXXXXXXXand XXXXXXXXXX.
In Moore v. United States, 160 U.S. 268, XXXXXXXXXX), the Supreme Court defined embezzlement in the following terms:
Embezzlement is the fraudulent appropriation of property by a person to whom such property has been entrusted, or into whose hands it has lawfully come. It differs from larceny in that the original taking was lawful, or with the consent of the owner, while in larceny the felonious intent must have existed at the time of the taking.
In Moore v. U.S., the plaintiff who was a late assistant postmaster of Mobile, Alabama was indicted and convicted of embezzling money of the UNITED States totaling $ 1, XXXXXXXXXXThere were four counts in the indictment. Upon two of the counts, two other defendants were acquitted. The fourth count, which he was convicted, charged that the said George S. Moore, being then and there an assistant, clerk, or employee in or connected with the business or operations of the United States post office in the city of Mobile, in the state of Alabama did embezzle the sum of sixteen hundred and fifty-two 59/100 dollars.
REASONS PEOPLE EMBEZZLE:
Embezzlement is a theft crime carried out by employees or others in a position of trust who know the business and exploit that knowledge for illegal gain. This type of economic crime is a crime that requires cold-blooded calculation and is often not reported to law enforcement or future employers, which allows offenders to steal again.
FINANCIAL DESPERATION/ PERSONAL GAINS:
The embezzlement process often begins with employee “borrowing” money that they intend to quickly repay. These financial demands on the embezzler continue, and eventually the employee cannot return the money. They may begin to feel as though the employer owes them or that the business would not run without the employee. Gradually an embezzling employee often continues to depend on this extra money for their ever expanding lifestyle.
Employees may be recruited by competitors to steal trade secrets, client lists, or intellectual property of the company for personal gain.
Laws relating to embezzlement:
Embezzlement is not a common-law crime but depends for its existence on statutory enactment. The principle variation in the state statues is as to the classes of persons subject to the statue. Some limit is to specified clerks and employees: others extend it to other type of agents and to corporate officers. The federal banks make no attempt to define the nature of the offense, but just specify the penalty for that employee. Embezzlement almost always involves some form of breach of trust by one having a position of trust or confidence towards the owner seeing that the embezzler somehow gained possession of the property and then converted it into his possession, such as a receiving teller with respect to money in or received through his cage. Also a bank messenger who delivered funds to the teller, then embezzlement, because his possession of the funds ended when he delivered them to the teller. If the messenger had taken the funds, before they reached the embezzlers do not start down the road of corruption until they have worked in banking at least seven years. It is very rare for them to begin at the first year of the job.
PUBLIC SERVICES FRAUD:
Medicaid / Medicare fraud
Medicate / Medicare program
Medicaid / Medicare fraud schemes
Workers’ Comp fraud
Workers’ was created
Workers’ Comp fraud schemes
Student Loan Fraud
Student Loan Fraud
Student Loan schemes
WELFARE FRAUD schemes
Stationary surveillance is conducted
Mobile surveillance is conducted
Document surveillance activities
Law enforcement uses surveillance as an investigative technique
Medicare Program Description:
CMS is the federal agency, which administers the Medicare Program. Currently, Medicare provides coverage to approximately 40 million Americans. Medicare is the national health insurance program for:
People age 65 or older
Some people under age 65 with disabilities
People with End- Stage Renal Disease (RSRD), which is permanent kidney failure requiring dialysis or a kidney transplant
The most frequent kind of fraud arises from a false statement or misrepresentation made or caused to be made that is material to entitlement or payment under the Medicare program.
The violator may be a physician or other practitioner, a hospital or other institutional provider, a clinical laboratory or other supplier, an employee of any provider, a billing service, a beneficiary, a Medicare Carrier employee, or any person in a position to file a claim for Medicare benefits:
Under the broad definition of fraud are other violations, including: the offering or acceptance of kickbacks and: or groups of individuals, sometimes employing sophisticated telemarketing and other promotional techniques to lure consumers into serving as the unwitting tools in the schemes. Rather, most are defrauding several private and public sector victims, such as Medicare, simultaneously.
The routine waiver of co-payments.
Fraud schemes range from those perpetrated by individuals acting:
- 43 % fraudulent diagnosis
- 34% billing for services not rendered
- 21 % Waiver of patient deductibles and co-payments
- 2% other
In Medicare, the most common forms of fraud include:
- Billing for services not furnished,
- Misrepresenting the diagnosis to justify payment,
- Soliciting, offering, or receiving a Kickback
- ,Unbundling or “ exploding” charges,
- Falsifying certificates of medical necessity, plans, of treatment, and medical records to justify payment, and
- Billing for a service not furnished as billed; i.e. upcoding
Examples of Some Common Actual Medicaid Fraud Schemes:
A Kid- Med clinic submits billings for physician office visits when the clinic has no licensed physician on staff.
A physician bills Medicaid for face-to- face office visits when she was vacationing outside the United States.
A dentist pays solicitors for each patient brought in to his clinic for dental services.
A home health nurse submits false time sheets for seeing patients who are actually hospitalized.
A TRANSPORTATION COMPANY BILLS FOR TRIPS NOT MADE AND EXAGGERATED MILEAGES (SUCH AS BILLING FOR MORE THAN 2,000 MILES IN AN 8 HOUR PERIOD.)
Workers’ compensation fraud
Workers’ compensation laws were created to prevent disputes over the compensation of individuals for on-the-job injuries. The laws
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Employer and Insurance Carrier Fraud:
In this type of fraud, employers or insurance carrier representatives purposely misrepresent a worker’s benefits entitlement in order to discourage him or her from pursuing a legitimate.
Premium fraud occurs when employers try to lower their insurance premium by fraudulently misstating their number of employees or the nature of their work.
Regardless of the legitimacy of the original claim, some medical or other health practitioners fraudulently maximize the number of medical reports and referrals in each case to increase the number of billings. They may also over bill insurance companies or render unnecessary treatment.
Public Sector Fraud:
Fraud committed against government entities is a disservice to all taxpayers. Some District Attorney’s Officers have specially assigned prosecutors who handle only those cases involving fraud committed within the public sector. Prosecution efforts are augmented by a comprehensive fraud prevention program. Prosecutors make presentations to employee groups about the benefits available for work- related injuries, while at the same time warning them of the consequences of committing fraud.
Responsibility of School
Food Stamp Program
GPS Phones/ GPS Tracking Devices
Weather it is Medicaid/ Medicare fraud, workers’ Comp fraud, student loan fraud, or Welfare fraud the basic scheme is to receive money for which you are not entitled. The methods can be falsifying applications, not reporting changes that would reduce or eliminate the benefits, charging for services never done, charging for more expensive procedures than those performed, or any other act of receiving money for which you are not entitled. It is a fraud committed for economic benefits.
Flax, Michael M. (2005). Economic Crimes (Criminal Investigations Series), Law Tech Custom Publishing, Inc.
(In your own words, referencing)