Lying, cheating, and stealing.
That’s white-collar crime in a nutshell. The term reportedly coined in 1939 is synonymous with the full range of frauds committed by business and government professionals.
White-collar criminals were violating something other than criminal law; they were violating some law, and that law was backed by state-sanctioned penalties; so conceived, criminals are individuals who break the law, regardless of whether contained in the criminal code or some other body of state regulations.
White-collar offenders violate real law with demonstrable legal intent. They are aware that what they are doing is wrong and they attempt to avoid legal punishment. In all these things, white-collar criminals are like conventional criminals. Where white-collar criminals differ from other criminals is the lack of shame they often display.
It’s not a victimless crime. A single scam can destroy a company, devastate families by wiping out their life savings, or cost investors billions of dollars. Today’s fraud schemes are more sophisticated than ever, and I am dedicated to using my skills to track down the culprits and stop scams before they start.
Accounting scandals are political and/or business scandals which arise with the disclosure of financial misdeeds by trusted executives of corporations or governments. Such misdeeds typically involve complex methods for misusing or misdirecting funds, overstating revenues, understating expenses, overstating the value of corporate assets or underreporting the existence of liabilities, sometimes with the cooperation of officials in other corporations or affiliates.
Occurs when a home’s appraised value is deliberately overstated or understated. When overstated, more money can be obtained by the borrower in the form of a cash-out refinance, by the seller in a purchase transaction, or by the organizers of a for-profit mortgage fraud scheme. Appraisal fraud also includes cases where the home’s value is deliberately understated to get a lower price on a foreclosed home, or in a fraudulent attempt to induce a lender to decrease the amount owed on the mortgage in a loan modification. A dishonest appraiser may be involved in the preparation of the fraudulent appraisal, or an existing and accurate appraisal may be altered by someone with knowledge of graphic editing tools such as Adobe Photoshop. Appraisal Independence is current law.
Securities and Commodities Fraud
Investment Fraud: These schemes, sometimes referred to as high yield investment fraud, involve the illegal sale or purported sale of financial instruments. Financial instruments are defined broadly as any contract that gives rise to a financial asset of one entity and a financial liability or equity instrument to another entity. These instruments can be a tradable asset of any kind, to include registered securities and commodities and unregistered securities (e.g. a simple promissory note between the fraudster and his/her victim investors). Schemes take on many forms, and perpetrators quickly alter schemes as they are thwarted by law enforcement. The typical investment fraud schemes are characterized by offers of low- or no-risk investments, guaranteed returns, overly consistent returns, complex strategies, or unregistered securities. These schemes often seek to victimize affinity groups—such as groups with a common religion or ethnicity—to utilize the common interests to build trust to effectively operate the investment fraud against them. The perpetrators range from professional investment advisers and hedge funds to those trusted and interacted with daily, such as a neighbor or sports coach. The fraudster’s ability to foster trust makes these schemes so successful, and investors should use scrutiny and gather as much information as possible before entering into any new investment opportunities. Investors can find background information on registered investment advisers at www.sec.gov and registered brokers and brokerage firms at www.finra.org. The following are additional definitions of the most common investment fraud scheme variations:
- Ponzi Schemes
- Pyramid Schemes
- Prime Bank Investment Fraud
- Advance Fee Fraud
- Promissory Notes
- Commodities Fraud
- Foreign Currency Exchange (Forex) Fraud
Mortgage fraud schemes employ some type of material misstatement, misrepresentation, or omission relating to a real estate transaction which is relied on by one or more parties to the transaction. These schemes include:
- Foreclosure rescue schemes
- Loan modification schemes
- Illegal property flipping
- Builder bailout/condo conversion
- Equity skimming
- Silent second
- Home equity conversion mortgage
- Commercial real estate loans
- Air Loans
Money laundering is the process by which criminals conceal or disguise the proceeds of their crimes or convert those proceeds into goods and services. It allows criminals to infuse their illegal money into the stream of commerce, thus corrupting financial institutions and the money supply, thereby giving criminals unwarranted economic power.
A proactive approach when investigating money laundering is recommended. After identifying a specified unlawful activity that generates illicit proceeds, a parallel financial investigation is conducted in order to locate the proceeds and prove their connection to the underlying crime.
Health Care Fraud
Health Care Fraud is carried out by many segments of the health care system using various methods. Some of the most prevalent schemes include:
Billing for Services not Rendered: These schemes can have several meanings and could include any of the following:
- No medical service of any kind was rendered.
- The service was not rendered as described in the claim for payment.
- The service was previously billed and the claim had been paid.
Upcoding of Services: This type of scheme involves a billing practice where the health care provider submits a bill using a procedure code that yields a higher payment than the code for the service that was truly rendered. The upcoding of services varies according to the provider type. Examples of service upcoding include:
- A routine, follow-up doctor’s office visit being billed as an initial or comprehensive office visit.
- Group therapy being billed as individual therapy.
- Unilateral procedures being billed as bilateral procedures.
- 30-minute sessions being billed as 50+ minute sessions.
Upcoding of Items: A medical supplier is upcoding when, for example, the supplier delivers to the patient a basic, manually propelled wheelchair, but bills the patient’s health insurance plan for a more expensive motorized version of the wheelchair.
Duplicate Claims: A duplicate claim usually involves a certain item or service for which two claims are filed. In this scheme, an exact copy of the claim is not filed a second time; rather, the provider usually changes a portion, most often the date of service on the claim, so that the health insurer will not realize the claim is a duplicate. In other words, the exact claim is not filed twice, but one service is billed two times, in an attempt to be paid twice for one service.