DataVisor Global Fraud Watch May 2021
Global fraud trends can give organizations an inside look at threats that might affect their business. They create fraud awareness and highlight the ongoing need for advanced fraud solutions to protect your company, employees, and customers. Here’s our May Global Fraud and Risk Report with some of the key takeaways from the past month.
Identifying Fraud in PPP Continues
A recent fraud case involving the Paycheck Protection Program shows the value in finding discrepancies in data. One Oklahoma businessman applied for a PPP loan, stating he had $40K in monthly payroll costs between five employees. However, the gap between what he claimed on his loan application vs. what he reported in paycheck withholdings was a dead giveaway that the loan was fraudulent.
Fraud solutions like DataVisor leave no stone unturned when it comes to identifying fraud. Even transactions that seem legitimate on the surface may have underlying details that don’t add up.
Fraud Can Take Years to Uncover
One recent fraud case spans 17 years, indicating that the longer someone can get away with their activities, the longer they engage in them. One woman in Montana received $325,000 in government benefits over the course of 17 years by lying to the Social Security Administration about her marital status, income, and living arrangements. Verifying all of the above can require multiple layers of investigation, which is why a multi-layered approach to fraud detection is such an important asset in identifying fraud.
Large-Scale Crime Rings Can Happen in Plain Sight
Medical insurance scams involving multiple providers and patients can be difficult to uncover because their span is so wide. And in many cases, some of the players may not even realize they are committing fraud in the first place.
This was the case with a natural wellness clinic in California. The owner, a chiropractor, targeted Medicare and TRICARE patients and instructed his staff to offer treatments, tests, and durable medical equipment to every patient, even if it wasn’t needed. When services didn’t qualify for insurance payment (which happened to be the majority of services provided by the clinic), the facility incorrectly billed the insurance companies using physical therapy codes, even though the providers performing the treatments weren’t licensed to perform physical therapy procedures.
The scheme extended into worker’s compensation, offering to provide a certain amount of durable medical equipment for every worker’s comp patient referred to his clinic. In total, the worker’s comp scheme collected more than $6.6 million in bills and affected 529 patients.
Advanced Fraud Solutions to Combat Global Fraud Trends
The above examples of fraud are multi-layered and require deep, time-consuming investigation to unravel. Advanced fraud solutions like DataVisor support fraud prevention and detection efforts to identify hidden connections between bad actors and activities.
Learn more about DataVisor fraud prevention solutions to stay ahead of global fraud trends as they evolve.
