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Compliance Into the Weeds

Compliance into the Weeds: COSO Fraud Risk Management Framework

The award-winning, Compliance into the Weeds is the only weekly podcast that takes a deep dive into a compliance-related topic, going into the weeds to explore a subject more fully and looking for some hard-hitting insights on sanctions compliance. Look no further than Compliance into the Weeds!

Get ready to dive into the fraud risk management and prevention world with Compliance into the Weeds, hosted by Tom Fox and Matt Kelly. In this episode, they break down the recently released fraud risk framework by COSO and the Association of Certified Fraud Examiners and how it’s necessary for today’s cyber-based fraud and cryptocurrency. They stress the importance of data analytics and internal hotlines to prevent fraud and that all employees need to be trained to detect and prevent fraud in their industry. The hosts also discuss how financial reporting controls may not always detect fraud and how anti-fraud controls are essential. With the rise of new types of fraud like ESG and greenwashing, the hosts recommend the fraud risk report for audit and compliance professionals to stay informed about risks swirling around corporations today. Take advantage of this informative and fascinating podcast. Tune in to Compliance into the Weeds now.

Key Highlights:

·      Fraud Risk Management: COSO Report 2nd Edition

·      Effective Fraud Prevention Training for Employees

·      Importance of Anti-Fraud Controls in Fighting Fraud

·      COSO Fraud Risk Guidance and the Fraud Pentagon

Notable Quotes:

“But when you think about it, we have a lot of external factors, such as the rise of cryptocurrency, which is riddled with fraud and corruption risk. New methods of cyber-based fraud, which didn’t exist, say, 2016, the 2010s before that. Rise of ransomware in particular, which wasn’t quite a big thing back then that it is all over the place now.”

“Most frauds, you the risk management function, you might never catch them. By looking for them, you’ll have to depend on somebody else coming to you from the enterprise, say, I think this person over here is doing something sketchy.”

“Fraud is having a moment. And fraud risk is on the forefront of many people’s minds from many different areas.”

“We need to do better at finding ways to assess and understand your fraud risk and then implementing new controls as necessary to push that risk down to acceptable levels.”

Resources

Matt 

LinkedIn

Blog Post in Radical Compliance

Tom 

Instagram

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YouTube

Twitter

LinkedIn

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FCPA Compliance Report

Mary Inman on Top FCA Recoveries and Issues from 2022

Welcome to the award-winning FCPA Compliance Report, the longest-running podcast in compliance. In this episode, I am joined by with Mary Inman, a partner at Constantine Cannon. We discuss the recently released US Fraud statistics and preventative measures with Inman. Inman explains that the US Department of Justice put out statistics on the False Claims Act for 2022, with healthcare dominating the recovered funds. Inman discusses how whistleblowers can still launch cases, even if the government does not join in, and encourage listeners to report fraud to their respective insurance departments if it later results in higher premiums for their organizations.

Key Topics:

·      The Increase of Managed Care Plans in Medicare [00:04:16]

·       The Power of Whistleblowing and the Impact of Joining Government Cases [00:08:19]

·      Medicare and Medicaid Fraud in California and Florida [00:12:21]

·       Impact of Insurance Fraud on Premiums [00:16:44]

·      The False Claims Act and the Escobar Decision [00:26:09]

Notable Quotes

1.      “And they were basically paying kickbacks to their they know who the physicians are, who are the largest prescribers of their drugs. And they were paying kickbacks to encourage them to basically discourage them from prescribing their competitors’ products and to direct it to them.”

2.     “What happened here is that Mallinckrodt improperly calculated their rebate by claiming that the drug they developed in 1990 was a new drug in 2013. And so that allowed them to greatly decrease the amount of the rebate they would have owed to the Medicaid program.”

3.    “It’s another kind of false billing scenario. It was notable to me that we had 2 big settlements.”

4.     “The whistleblower had accused the Association of shifting costs that it shouldn’t have reimbursed onto the Florida Medicaid program.

 Resources:

Mary Inman on Linkedin

Constantine Cannon

Tom Fox on LinkedIn