VA Office of Inspector General Criminal Investigations Division Fraud Awareness Briefing.
-
Upload
rodney-may -
Category
Documents
-
view
216 -
download
1
Transcript of VA Office of Inspector General Criminal Investigations Division Fraud Awareness Briefing.
VA Office of Inspector VA Office of Inspector GeneralGeneral
Criminal Investigations Criminal Investigations DivisionDivision
Fraud Awareness Fraud Awareness BriefingBriefing
VA Office of Inspector VA Office of Inspector GeneralGeneral
Audit DivisionAudit Division
Healthcare InspectionsHealthcare Inspections
Administrative Investigations Administrative Investigations DivisionDivision
Criminal Investigations DivisionCriminal Investigations Division
Investigate violations of federal law Investigate violations of federal law involving VA Programs and facilities.involving VA Programs and facilities.
Special AgentsSpecial Agents arrest authority, carry firearms, execute arrest authority, carry firearms, execute
search warrants, conduct undercover search warrants, conduct undercover operationsoperations
Subjects of InvestigationSubjects of Investigation
VeteransVeterans VA beneficiariesVA beneficiaries VA fiduciariesVA fiduciaries VA employeesVA employees
HealthcareHealthcare BenefitsBenefits
VA contractors/vendors/granteesVA contractors/vendors/grantees Private citizensPrivate citizens
Cases we investigateCases we investigate
From complex contract fraud to From complex contract fraud to homicide.homicide.
Prosecutable crimes that affect VA.Prosecutable crimes that affect VA. Federal Criminal/Civil StatutesFederal Criminal/Civil Statutes Washington State Penal CodeWashington State Penal Code Local RegulationsLocal Regulations
Main Entry: Main Entry: fraudfraud Pronunciation: 'frodPronunciation: 'frodFunction: Function: nounnounEtymology: Middle English Etymology: Middle English fraude, fraude, from Middle from Middle French, from Latin French, from Latin fraud-, frausfraud-, fraus1 a1 a : : DECEIT, , TRICKERY; ; specificallyspecifically :: intentional intentional perversion of truth in order to induce another to part perversion of truth in order to induce another to part with something of value or to surrender a legal right with something of value or to surrender a legal right bb :: an act of deceiving or misrepresenting an act of deceiving or misrepresenting : : TRICK2 a2 a :: a person who is not what he or she pretends to a person who is not what he or she pretends to be be : : IMPOSTOR; ; alsoalso :: one who defrauds one who defrauds : : CHEAT bb :: one that is not what it seems or is represented to beone that is not what it seems or is represented to be
synonymsynonym see see DECEPTION, , IMPOSTURE
Define “FRAUD”Define “FRAUD”
Types of CrimeTypes of Crime
FraudsFrauds VBA FraudsVBA Frauds VHA FraudsVHA Frauds
General CrimesGeneral Crimes primarily associated with VHAprimarily associated with VHA
Types of Fraud Types of Fraud Cases/VBACases/VBA
EmbezzlementEmbezzlement Theft of Benefits Theft of Benefits False StatementsFalse Statements Equity Skimming/Loan GuaranteeEquity Skimming/Loan Guarantee Construction FraudConstruction Fraud
Types of Fraud Types of Fraud Cases/VBACases/VBA
Deceased Payee CasesDeceased Payee Cases Credit Card FraudCredit Card Fraud Fiduciary FraudFiduciary Fraud Disability and Workers’ Disability and Workers’
Compensation FraudCompensation Fraud
Types of Fraud Types of Fraud Cases/VHACases/VHA
EmbezzlementEmbezzlement Theft of BenefitsTheft of Benefits Identity TheftIdentity Theft Theft of Government PropertyTheft of Government Property Procurement FraudProcurement Fraud
General Crimes affecting General Crimes affecting VHAVHA
Drug DiversionDrug Diversion For ProfitFor Profit For UseFor Use
Theft of PropertyTheft of Property Child PornographyChild Pornography Patient AbusePatient Abuse HomicideHomicide
patient by patientpatient by patient patient by staffpatient by staff
When you should call us.When you should call us.
Whenever you think Whenever you think something is wrong and something is wrong and there may be criminal there may be criminal conduct involved.conduct involved.
Call us early, when Call us early, when allegation first surfaces.allegation first surfaces.
Many referrals don’t Many referrals don’t result in cases.result in cases.
Encourage informal Encourage informal contacts.contacts.
38 CFR 1.38 CFR 1.201201 Employee's duty to report. Employee's duty to report. 38 CFR 1.38 CFR 1.203203 Information to be reported to Information to be reported to
VA Police.VA Police.
38 CFR 1.38 CFR 1.204204 Information to be reported to Information to be reported to the Office of Inspector General. Criminal the Office of Inspector General. Criminal matters involving felonies will also be matters involving felonies will also be immediately referred to the Office of immediately referred to the Office of Inspector General, Office of Investigations. Inspector General, Office of Investigations.
VAOIG HotlineVAOIG Hotline
1-800-488-82441-800-488-8244
VA Inspector General HotlineVA Inspector General Hotline
P.O. Box 50410P.O. Box 50410
Washington, DC 20091Washington, DC 20091
[email protected]@va.gov
FAX: 202-565-7936FAX: 202-565-7936
North Western Field North Western Field OfficeOffice
Northern CaliforniaNorthern California• San FranciscoSan Francisco• FresnoFresno
Northern NevadaNorthern Nevada• RenoReno
OregonOregon
Washington StateWashington State
IdahoIdaho
MontanaMontana
Special Agent in ChargeSpecial Agent in Charge
Michael SeitlerMichael Seitler
(510) 637-6360(510) 637-6360
Western Field OfficeWestern Field Office
Southern CaliforniaSouthern California• Los AngelesLos Angeles• San DiegoSan Diego• BakersfieldBakersfield
ArizonaArizona
New MexicoNew Mexico
Sothern NevadaSothern Nevada• Las VegasLas Vegas
UtahUtah
Asst. Special Agent in Asst. Special Agent in ChargeCharge
Lisa MantioneLisa Mantione
310-268-4269310-268-4269
Donald PepinDonald Pepin
UNITED STATES ATTORNEY'S OFFICE UNITED STATES ATTORNEY'S OFFICE Western District of WashingtonWestern District of Washington
November 20, 2009November 20, 2009
CAMANO ISLAND MAN INDICTED FOR CAMANO ISLAND MAN INDICTED FOR SCHEME TO STEAL AND SELL DIABETIC SCHEME TO STEAL AND SELL DIABETIC
SUPPLIESSUPPLIES
Former Pharmacy Employee Conspired with Former Pharmacy Employee Conspired with Florida Resident to Sell Stolen Insulin and Florida Resident to Sell Stolen Insulin and
Test StripsTest Strips
VA OIG InvestigationVA OIG Investigation
Los Angeles VAMC Pharmacy Los Angeles VAMC Pharmacy Determined:Determined:
• Incoming orders of test strips outpaced Incoming orders of test strips outpaced demanddemand
• Test strips had unique lot numbersTest strips had unique lot numbers
• Unusually high warehouse activity by: Unusually high warehouse activity by:
??
VA OIG InvestigationVA OIG Investigation
VA OIG InvestigationVA OIG Investigation
VA OIG InvestigationVA OIG Investigation
Above SuspicionAbove Suspicion
Doctor of PharmacyDoctor of Pharmacy
SupervisorSupervisor
Always volunteered for overtimeAlways volunteered for overtime
Had private officeHad private office
Had all access - trustedHad all access - trusted
VA OIG InvestigationVA OIG Investigation
SuspiciousSuspicious
Supervisor - Not scrutinizedSupervisor - Not scrutinized
Always volunteered for overtime Always volunteered for overtime
– – why? Money problems? - opportunitywhy? Money problems? - opportunity
Had private officeHad private office- Out of sight- Out of sight
Had all access – trustedHad all access – trusted- Had no job duties in the warehouseHad no job duties in the warehouse
- History of crimes against the VA- History of crimes against the VA
White-collar crimeWhite-collar crime
Within the field of Within the field of criminology, white-, white-collarcollar crime crime has been defined by has been defined by Edwin Sutherland as "a crime as "a crime committed by a person of committed by a person of respectability and high social status respectability and high social status in the course of his occupation" in the course of his occupation" (1949). (1949).
Think about it…HmmmThink about it…Hmmm
MotiveMotiveAbilityAbilityOpportunityOpportunity
OpportunityOpportunity
Opportunity for Opportunity for fraud, , briberybribery, , insider insider tradingtrading, , embezzlementembezzlement, , computer computer crimecrime, , identity theftidentity theft, and , and forgeryforgery is is more available to more available to white-collarwhite-collar employees.employees.
Think about it…HmmmThink about it…Hmmm
Lost VA Job (Resigned in lieu of termination)Lost VA Job (Resigned in lieu of termination)
Facing criminal prosecution for thefts from 2005 – 2010:Facing criminal prosecution for thefts from 2005 – 2010: Conspiracy - 5 years / $250,000 fine. Conspiracy - 5 years / $250,000 fine. Wire Fraud - 20 years / $250,000 fine. Wire Fraud - 20 years / $250,000 fine. Transportation of Stolen Property – 10 years / Transportation of Stolen Property – 10 years /
$250,000$250,000 Receipt of Stolen Property - 10 years / $250,000Receipt of Stolen Property - 10 years / $250,000
Estimated gross sales of $140,000Estimated gross sales of $140,000
Fertility treatmentsFertility treatments
Ounce of PreventionOunce of Prevention
Physical Security ControlsPhysical Security Controls Need for accessNeed for access Cop on the beatCop on the beat
Management ControlsManagement Controls Duty to reportDuty to report AccountabilityAccountability InventoryInventory Separation of dutiesSeparation of duties Mandatory WitnessMandatory Witness
Take Away!Take Away!
Call the VA OIG upon suspicionCall the VA OIG upon suspicion M – O – AM – O – A Don’t circumvent the controlsDon’t circumvent the controls Don’t tolerate thieveryDon’t tolerate thievery
Thomas OberhoferThomas Oberhofer(310) 268 - 4788(310) 268 - 4788