The healthcare industry is big business in America. It also receives a significant amount of government spending. Medicaid, for example, results in over $400 billion a year in benefits. Medicare adds another $600 billion. Total spending on healthcare in the United States amounts to about 17% of our total Gross Domestic Product (GDP) at about $2.7 trillion. With so much at stake, it is no wonder the industry is fraught w...

What motivates a person to do the right thing in the face of opposition? How do people know which path to take when faced with a conflict of interest? These questions are the subject of philosophical debates, timeless works of fiction and endless scientific research. We often ask ourselves how we might respond to an ethical conundrum. If you’ve ever taken an ethics course, then you’ve probably mulled over hypothetical sit...

For every $100 we spend on healthcare in the United States, as much as $10 is lost completely. It doesn’t go toward a sick grandmother who depends on Medicare. It doesn’t go toward the poverty-stricken family in need of funds to pay for a sick family member. It doesn’t even go to the less emotionally appealing aspects of our healthcare system, like document processing or claims management. That $10 is simply gone. Whe...

Fraud against the government is ever-changing and, it seems, ever-increasing, especially in the rather specialized areas that involve accounting frauds. One corner of accounting fraud that is frequently exploited is the problem of cross-charging. While cross-charging sometimes requires a partner, it is not necessarily a complicated scam to execute and the fraud can be challenging for an outside auditor to detect. Cross-chargin...