The study summarized here examined the fraud-control apparatus currently used within the health care industry, and assessed the assumptions, policies, and systems that constitute the industry's current approaches to fraud control. The objective was to develop a better understanding of the strengths and weaknesses of existing approaches. Since 1992, with Health Care Reform under debate, the issu...

Using cross sectional data Psychological vulnerability was identified as a correlate of older adult's being defrauded. We extend that research by examining fraud prevalence using longitudinal data from the Health and Retirement Study, and to identify the best predictors of fraud longitudinally across a 4-year time frame. Whereas reported fraud prevalence was 5.0% in a 5-year look-back period in...

Fraud and security continue to be problems for firms. Fraud information is typically incomplete and deliberately obfuscated. These qualities make fraud events harder to detect using conventional security controls. This study uses a knowledge management framework to explore how different types of controls are used to detect and investigate information fraud. The analysis is based on the customer...

Fraud presents an immense problem for health insurance companies and the only way to fight fraud, is by using specialized fraud management systems. Current research community has focused great efforts on different fraud detection techniques, while neglecting other also important activities of fraud management. We propose a holistic approach that focuses on all 6 activities of fraud management, ...

The purpose of this study is to determine the influence diamond fraud elements consisting pressure (which are proxied with financial stability, external pressure, and targets), oppoturnity by nature industry ineffective monitoring), rationalization audit opinions, capability changing directors statements. This research uses a qualitative descriptive method secondary data sources collected throu...

We present an example of a nancial market consisting of a deterministic bond and two risky nancial assets (S 1 t ; S 2 t) 0tT such that, for an agent whose preferences are modeled by expected exponential utility at time T , it is optimal to constantly hold one unit of asset S 1. However, if we pass to the market consisting only of the bond and the rst risky asset S 1 , this trading strategy is ...