7th Annual Fraud & Computer Crimes Seminar

Please make your reservations for the Tampa Bay Chapter's 7th Annual Fraud & Computer Crimes Seminar. Information is available on our web site at: http://tampabaycfe.org/seminar.htm.

Internet Scams
Fraud Trends
January-December 2005

2005 Trends

· The total loss in 2005 was $13,863,003, significantly higher than the $5,787,170 reportly lost in 2004.
· NCL received more complaints in 2005: 12,315 compared to 10,794 in 2004, but that does not account for the more than doubling of total loss.
· The average loss in 2005 was $1,917, also much higher than the $895 average loss in 2004.
· For the first time since NCL began collecting Internet fraud complaints in 1997, wire transfer was the most common method of payment in 2005.
· The most expensive scam among the Top 10 was Nigerian Money Offers. 42 people reported losing money to this scam in 2005, compared to 18 in 2004, 12 in 2003, seven in 2002, ten in 2001, and one in 2000.
· Among the Top 10 Scams, those with the most consumers age 60+ were Phishing (21 percent), Lotteries/Lottery Clubs (21 percent), Adult/Information Services (20 percent), and Nigerian Money Offers (12 percent).
· Those with the most consumers under age 30 were Work-at-Home Plans (44 percent) and Advance Fee Loans (35 percent)

Top Ten Scams

TRAINING

Tampa Bay Chapter

7th Annual Fraud & Computer Crimes Seminar

May 9 - 10, 2006
Ruth Eckerd Hall
1111 McMullen Booth Road
Clearwater, FL 33759

Association of Certified Fraud Examiners

Building Your Fraud Examination Practice

CPE Credits: 8 hours
06/12/2006

Analyzing Written Statements

CPE Credits: 16 hours
06/13-14/2006

Walt Disney World Dolphin
1500 Epcot Resorts Blvd.
Orlando, FL 32830
(407) 934-4000

17th Annual ACFE Fraud Conference and Exhibition

CPE Credits: 44
7/9/2006 - 7/14/2006

The Venetian
3355 Las Vegas Blvd.
Las Vegas, NV  89109
(877) 283-6423
(702) 414-1000 (Fax)
Room Rate: $169.00 - subject to availability

2005 - 2006
OFFICERS & DIRECTORS

PRESIDENT
Steve Hooper, CIA, CFE, CCSA
Clerk of the Circuit Court Hillsborough County, FL
(813) 276-2029 x3703

VICE PRESIDENT
Christine Dever, CPA, CFE

SECRETARY
Kara Preston, CFE
Polk County Sheriff's Office
(863) 499-2400

TREASURER
Laura Krueger Brock, CFE, CPA
Cherry, Bekaert, Holland, LLP
(727) 822-8811

DIRECTOR
Mark Dubina, CFE
Florida Department of Law Enforcement
(813) 878-7366

DIRECTOR
Ellen Wilcox, CFE
Florida Department of Law Enforcement
(727) 298-2482

DIRECTOR
Penny Borjas, CFE, CIA
ACL Certified Trainer

CHAPTER TRAINING
Wayne Boytim, CFE
City of Tampa, Internal Audit
(813) 274-7167

News from the ACFE

CFE Designation Officially Recognized as FBI Critical Skill Set
The Certified Fraud Examiner (CFE) designation has been officially recognized as an FBI critical skill set, under the Diversified Special Agent hiring subprogram. The FBI recognizes the positive effect that CFEs can have not only in criminal investigations, but in counterterrorism and counterintelligence as well.

The honor gives CFEs a competitive edge and the opportunity to pursue careers as Special Agents, while enhancing the esteem and professional regard for CFEs everywhere.

ACFE Online Learning Makes Debut
The ACFE announced the successful debut of the first in a series of new learning opportunities for anti-fraud professionals. On March 30, 2006, Financial Analysis for Non-Experts was offered live as the first ACFE Online Learning course, with two additional courses upcoming: Practice Management: Malpractice Insurance (May 11, 2006) and Know Your Customer Programs (June 29, 2006). Courses are also available in archived form after being conducted live.

Corey Ann Bloom Elected Chair of ACFE Board of Regents
Corey Anne Bloom, CFE, CA, CA•IFA has been elected Chair of the ACFE Board of Regents. Bloom is a Senior Associate at RSM Richter Inc., a Canadian leader involved in major consulting and business advisory mandates. She has accumulated over 15 years of experience in fraud investigations, forensic accounting and auditing. Read her bio here.

NEW!
Criminology and Ethics Toolkit

This quartet of resources is uniquely composed to assist professionals further their knowledge of the culture that enables fraud and learn the techniques recommended in fraud prevention.

$145 ACFE Members/ $226 Non-Members
Visit www.ACFE.com/Shop -- Where the Experts Shop.

Contributing Author Opportunity for ACFE Members!

Share your fraud case study with the ACFE, and be recognized for your expertise as a contributing author. The ACFE composes an informative column, "Fraud Findings," which is published monthly in Internal Auditor magazine. "Fraud Findings" provides another opportunity for the ACFE to share our members' own experiences and successes in fighting fraud, in the interest of helping others who face the same challenges.

To be considered, please submit a narrative summary of a fraud case, including how the case was perpetrated, how it was detected, and several examples of "lessons learned" from the case. The total write-up should be approximately 1,500 words and should focus on the internal auditor's role in preventing/detecting the fraud. Please send submissions to John Gill, CFE, J.D. at jgill@ACFE.com while column editor Andi McNeal, CFE is on maternity leave.”

Chapter News

Chapter Elections

It is official . . . the lineup for next year is: Christine Dever, President; Gary Chapman, Vice President; Laura Krueger Brock, Treasurer; Bill Miles, Secretary; Steve Hooper, Director; Mark Dubina, Director; and Ellen Wilcox, Director. Continuing in the role of Chapter Training Director - Wayne Boytim.

Perfect Attendance

Our hats go off to the following chapter members who attended all 6-dinner meetings this past chapter year. Wayne Boytim, Debbie Cook Riveros, Christine Dever, Stephen Menge, Bill Miles, and Kara Preston were present for every meeting.

Scholarship Winner

Jeannine Antozzi was selected by the Chapter Board of Directors to receive a $500 graduate student scholarship. She was admitted to the MBA Program at the University of South Florida St. Petersburg in January 2006.

Recently, Jeannine completed an Interdisciplinary Forensic Training program at the main USF campus in Tampa. While in her undergraduate accounting/finance program at Florida State University, Jeannine maintained a 3.4 GPA. At Florida State, she was in the Best Buddies Program where she was paired with a mentally handicapped girl and participated in various activities with her.

Our congratulations to Jeannine!

Dinner Meeting News

Fraud & Abuse in Healthcare

Wow! What a great presentation by Alice Pandolfi. Healthcare fraud is more prevalent than most average citizens realize. And why shouldn’t it be? It’s so easy to do. All anyone needs to commit healthcare fraud and abuse is a social security number, a tax ID, a CPT manual and an ICD-9 book. Although a Doctor’s office would be helpful, provider fraud can occur by employees in hospitals, home health care agencies, DME companies, by ambulance services, clinics, and laboratories.

Luckily there are just as many sources who report healthcare fraud: claims processors, claims analysts, law enforcement, law firms, and by software that detects aberrancies. The estimated 3-10% of fraudulent healthcare claims does not seem like a huge percentage until a monetary figure is applied to it. A whopping $57,000 per minute is attributed to medical fraud wrong doing.

Before the days of HIPPA, computers, paperless technology, and so many stringent privacy laws, patients completed their own insurance claims. Insurance companies relied on the honesty of the patient to advise which procedures were performed and qualified for reimbursement. Now the providers are responsible for this tedious task. With every single imaginable medical procedure and item having an assigned numeric code, some mistakes are to be expected. However, there are many more intentional errors committed, such as unbundling. Unbundling is taking a procedure such as pregnancy which is normally billed as one procedure and instead, the doctor “unbundles” the charge and charges it as individual procedures.

Another common act is unnecessary testing. As a patient, it is so hard to know when unnecessary testing is being done, especially, if you are going in to the doctor for an undiagnosed problem. But if you go in for elbow pain and an ultrasound is ordered for your gall bladder, there might be a problem. It is even more frustrating when you receive your insurance company’s explanation of benefits and all you see are medical codes.

There are many more schemes that occur on a daily basis by doctors of all size medical practices and education level. Some potential fraud indicators are providers offering free gifts to use the clinic, an unwillingness to release medical records, misspelled medical terminology, using a P.O. Box as a place of service, altered dates, amounts or descriptions. As a fraud investigator, one might also look for indicators such as a pressure to pay claim from the provider, the doctor treating multiple patients in one family, and anonymous inquiries on the claim. Like in all sticky situations in life, the most important factor is your gut feeling. Listen to yourself and question any practices that you feel are not right.

Alice H. Pandolfi RN, CFE, AHFI, former Director Special Investigations Unit, WellCare, recently retired. Alice went to Nursing School in Boston in the late sixties. In 1985, she joined Aetna in Connecticut for a nearly 20 year journey, the last 10 years managing their Special Investigations Unit. Along the way she acquired her Masters in Management from Renssellaer, her Certified Fraud Examiner designation and AHFI accreditation. In addition, Alice is board certified in Quality Assurance, Utilization Review and Managed Care. Recently moved to Florida, she joined WellCare as their Director of Special Investigations. Alice is presently on the Board of Governors for the National Health Care AntiFraud Association.

Submitted by: Kara Preston, Chapter Secretary (Thank you Kara for doing an outstanding job this past year, Gary)

Bronson Warns Consumers To Avoid ‘Jury Duty’ Scam

TALLAHASSEE -- Florida Agriculture and Consumer Services Commissioner Charles H. Bronson today alerted consumers to a growing identity theft scam in which con artists posing as courthouse workers claim that the person being called has failed to report for jury duty.

The scam has been reported in 11 states, although it is unclear whether it has surfaced in Florida, officials say.

“If you get such a call, hang up and avoid providing any personal or financial information over the phone,” Bronson said. “Court workers don’t call on the phone to inform you that you’ve missed a jury duty summons.”

The scam typically involves a call from a person claiming to be a jury coordinator who informs the person being called that a warrant has been issued for his or her arrest as a result of the person’s failure to appear for jury duty. When the intended victim protests and reports that they’ve never received a summons to report for jury duty, they are asked for a social security number, a date of birth and sometimes even a bank account number.

Providing that information enables the scam artist to clean out the consumer’s bank account and open up other accounts, obtain credit cards and establish other lines of credit in the victim’s name, Bronson warned.

“This is a particularly insidious fraud because most people take jury duty seriously and naturally would want to clear up any misunderstanding about whether they failed to show up for it as quickly as possible,” the Commissioner said. “Such a call would understandably upset most people, especially with the threat of arrest, and catch them off guard.”

The scam reportedly has surfaced in New York, Minnesota, Illinois, Colorado, Oklahoma and other states in recent years, and authorities are concerned that it will spread.

It is yet another example of how con artists try to rip off consumers.

“People need to always remember to avoid giving any personal or financial information over the telephone to anyone whose identity they have not verified,” Bronson said.

Practice Management: Malpractice Issues

May 11, 2006 at 2:00 pm EST
Duration: 100 minutes

CPE: 2 hours

Thinking about opening your own fraud examination firm, adding the practice onto an established services firm, or just assessing the state of your firm?  There are many elements to consider in building your successful business, and of course, assessing the risk of malpractice should be a priority.

In this litigious society, no matter how good you are, a claim can still be filed against you.  That's why the wise practitioner plans for the risk of malpractice claims regardless of his or her expertise or years in practice.  This ACFE Online Learning seminar will describe the most common liability risks for fraud examiners, the types of insurance available to cover those risks and tips on how to obtain coverage.

Even though you may have a good insurance policy, the real key is to do everything you can to keep from having to use it.  This session will also discuss high-risk areas in terms of clients retained and services offered.  We will also explore the impact of issues such as regulation and technology trends on the level of risk in engagements.

Topics include:

 - Liability risks for fraud examiners

 - Types of professional liability and malpractice insurance

 - Tips and suggestions on obtaining liability coverage

 - Loopholes in policies to watch out for

 - Steps to take if a claim is filed against you

Presenter:

Tracy L. Coenen, CFE, MBA, CPA

President, Sequence Inc., Milwaukee, WI

Tracy L. Coenen is seen as an innovator, both for her entrepreneurial style and her vision within the field of accounting.  Her top-notch investigative intuition, coupled with exceptional technical expertise has made her a sought-after expert in the world of fraud and litigation.

President's Message

I want to say thanks from the bottom of my heart to all of you for the kind words and prayers that you gave during the recent sickness and passing of my Mom. Words can never express my sincerest thanks to you. I want to thank Christine Dever for stepping in and conducting the March meeting in my absence.

On the brighter side, we again, had an outstanding dinner meeting on April 11th. It was the last dinner meeting of the current chapter year. Attendance was down slightly but for those who were there, we had an excellent presentation on Health Care Fraud given by Alice H. Pandolfi , the Director of the Special Investigations Unit of WellCare.

We had three newcomers attending the dinner meeting. A special welcome went out to Dina Castellano from Wellcare; David Goddu, from Cherry, Bekaert & Holland, and Roger Strout, who announced he is presently providing consultant work but would be glad to leave a resume if anyone was interested. If anyone needs to contact Roger, drop me an email and I will see he gets the message.

I awarded another of the Chapter’s $500 academic scholarships to Jeannine Antozzi, who is in the MBA Program at USF – St. Petersburg. While in her undergraduate accounting/finance program at Florida State University, Jeannine maintained a 3.4 GPA. Good luck to Jeannine as she continues to achieve her academic goals.

Our two-day “7th Annual Fraud and Computer Crime Seminar” is coming May 9th and 10th. Details of the seminar are posted on our website. Christine has done an excellent job in putting together this year’s list of speakers and topics.

Since this was our annual administrative meeting, the names of our newly elected officers were announced for the 2006 – 2007 Chapter year. They are:

Christine Dever President
Gary Chapman Vice President
Laura Brock Treasurer
Bill Miles Secretary

Congratulations to our new officers.

I look forward to seeing everyone at the 7th annual Fraud and Computer Crimes seminar. If you haven’t registered as of yet, I would recommend you do so by April 30th to save on paying a later registration fee. Again, my thanks to all.

Steve Hooper, CFE, CIA, CCSA