Business Commons^™

The Association Fallacy – Fraud And Financial Reporting Quality In The Customer-Supplier Relationship, Nicholas Willett

Honors Scholar Theses

As with individuals, corporate entities are vulnerable to committing logical fallacies in the decision-making process. One such fallacy that has been observed across multiple disciplines is the phenomenon of guilt by association, here referred to as the “association fallacy.” In this study, I demonstrate the existence of the association fallacy within historical customer-supplier relationships, during which the supplier is named in an SEC Accounting and Auditing Enforcement Release (AAER). A panel regression is employed to track indicators of customer earnings management behavior in the years before, during, and after the supplier AAER. A cross-sectional analysis is also used to assess …

Upcoding Medicare: Is Healthcare Fraud And Abuse Increasing?, Alberto Coustasse, Whitney Layton, Laikyn Nelson, Victoria Walker

Management Faculty Research

Medicare fraud has been the cause of up to $60 billion in overpaid claims in 2015 alone. Upcoding occurs when a healthcare provider has submitted codes for more severe conditions than diagnosed for the patient to receive higher reimbursement. The purpose of this study was to assess the impact of Medicare and Medicaid fraud to determine the magnitude of upcoding inpatient and outpatient claims throughout reimbursements.

The methodology for this study utilized a literature review. The literature review analyzed physician upcoding throughout present on admission infections, diagnostic related group upcoding, emergency department, and clinic upcoding. It was found that upcoding …

Predictors Of Fraudulent Monday Effect Workers Compensation Claims Filing, Sharla St. Rose

FIU Electronic Theses and Dissertations

Monday Effect Claims refer to workers compensation claims filed on Mondays for easy to conceal injuries such as strains, sprains, and back injuries. Researchers and industry experts have long believed that there is an element of fraud in these claims, resulting from individuals who were injured during the weekend, while not at work, looking to take advantage of the medical benefits available through workers compensation insurance. Fraudulent Monday Effect Claims (FMEC), as presented in this study, specifically refer to workers compensation claims filed for injuries that occurred while an individual was not at work, presumably during the weekend.

A study …

J Mich Dent Assoc April 2021

The Journal of the Michigan Dental Association

In the April 2021 issue of the Journal of the Michigan Dental Association, we offer a comprehensive range of original feature content showcasing the latest developments in dental practice and knowledge, including:

1. AI in Dental Care Delivery: Explore the groundbreaking role of Artificial Intelligence (AI) and Machine Learning in dental care, revolutionizing efficiency, safety, care outcomes, and treatment planning consistency.
2. AI in Dental Claims Processing: Discover how AI is employed by third-party payers to streamline dental claims processing, resulting in cost containment and the proactive identification of potential fraud, waste, and abuse.
3. Evidence-Based Dentistry: As part of …

Mitigating Financial Fraud Risk With Data Analytics, Clarence Goh, Gary Pan

Research Collection School Of Accountancy

The risks associated with financial fraud that modern CFOs face today is particularly high. The same report examined Accounting and Auditing Enforcement Releases (AAERs) issued by the Securities and Exchange Commission (SEC) in the US from 2014 to 2019 and found that while the SEC frequently charged the person directly responsible for perpetuating the financial fraud, the CFO was among the most commonly charged employees. Data analytics techniques can play an important role in mitigating the risk of financial fraud for CFOs.

Exploring The Impact Of Incentives On Management Behavior, Chen Zhao

Graduate Theses, Dissertations, and Problem Reports

This dissertation is comprised of three studies that examine the impact of incentives on management behavior to complement agency problems literature. The first paper studies whether incentives associated with firm life cycle stages impact management disclosure quality. The second paper explores these incentives more deeply and investigates whether the likelihood of fraud is different across life cycle stages. The third paper examines whether rating agencies play a role in alleviating agency problems in nonprofit organizations by increasing public exposure and reducing information asymmetry.

Study one examines the relationship between firms’ life cycle stages and disclosure quality. Life cycle stages are …