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| Section | Objectives |
|---|---|
| Fraud Schemes | - Financial Statement Fraud
|
| Fraud Investigation and Analysis | - Evidence collection and documentation
|
| Financial Crimes | - Banking and Payment Fraud
|
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NEW QUESTION # 73
Which of the following actions can make mobile payments more secure?
Answer: A
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Biometric authentication (e.g., fingerprint, facial recognition) strengthens payment security by ensuring that only the authorized user can approve transactions, reducing the risk of unauthorized access even if credentials are stolen.
* Analysis of Incorrect Options:
* A - Using the same credentials increases exposure to credential-stuffing attacks.
* C - Disabling biometrics weakens, not strengthens, security.
* D - Incorrect since B is valid.
* Key Concept: Cyberfraud prevention - authentication and mobile payment controls.
Reference: ACFE Manual, Fraud Prevention and Deterrence - Cybersecurity Measures .
NEW QUESTION # 74
Which of the following must be present for a fraud to exist?
Answer: B
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: For fraud to exist, several legal elements must be established. These include: (1) a material false statement made by the perpetrator, (2) knowledge of the falsity of that statement (scienter or intent to deceive), and (3) reliance on the false statement by the victim, resulting in harm or damages. The Fraud Examiners Manual (2020 International Edition) explains that all elements must be present for a fraud case to be sustained. Thus, the correct answer is D. All of the above .
* Analysis of Incorrect Options (Distractors):
* A. A material false statement - A false statement alone is insufficient unless there is intent to deceive and victim reliance.
* B. Knowledge that the statement was false when it was uttered - Intent is critical, but without the victim's reliance and damages, fraud is incomplete.
* C. Reliance on the false statement by the victim - Victim reliance is necessary, but without a knowingly false statement and intent, fraud cannot be proven.
* Key Concept: The essential legal elements of fraud.
Reference: ACFE Fraud Examiners Manual (2020 International Edition) , Law section - The Law Related to Fraud , which explains the legal foundation and elements necessary to establish fraud.
NEW QUESTION # 75
Which of the following scenarios is an example of upcoding ?
Answer: B
Explanation:
Comprehensive and Detailed Explanation
Definition of Upcoding (ACFE Manual Reference)
The ACFE Manual identifies upcoding as a type of health care billing fraud in which the provider submits a claim for a more expensive or more complex service than what was actually provided.
Although the exact term "upcoding" appears within the health care fraud discussions, the broader category is part of Financial Transactions and Fraud Schemes concerning fraudulent billing practices . The manual describes fraud schemes in which the perpetrator:
* Bills for services not provided ,
* Bills for more expensive services than were actually delivered, or
* Uses codes that misrepresent the level or nature of medical procedures.
Upcoding specifically involves:
Billing for a higher-cost procedure than what was actually performed, by using a code representing a more expensive service.
Why Option D Is Correct
Dr. Raul advised a patient with a small fracture to use crutches, but he submitted a claim using a code indicating that he placed a cast on the patient.
* Actual service: Advice and crutches
* Billed service: Application of a cast (more expensive procedure)
This is a textbook example of upcoding , as the provider is using a higher-cost CPT code to obtain greater reimbursement than the service warrants.
Why the Other Options Are Incorrect
Option A - Not Upcoding
Cindy receives a payment to undergo an unnecessary procedure , which is then billed fraudulently.
This is medically unnecessary services fraud , not upcoding.
Option B - Not Upcoding
Dr. Loomis uses three procedure codes instead of one .
This is an example of unbundling , which involves billing separate codes for procedures that should be billed as a single package.
Option C - Not Upcoding
Landon inflates the amount of a medical bill he wants reimbursed.
This is billing inflation or overstatement , but not misrepresentation via coding.
ACFE Manual Supporting Reference
The Manual's section on fraudulent billing schemes discusses cases where perpetrators misrepresent medical procedures , including using false or inflated codes to obtain higher reimbursements.
NEW QUESTION # 76
Which of the following statements regarding using front businesses as a method of laundering money is MOST ACCURATE?
Answer: B
Explanation:
The correct answer is D. Front businesses are attractive for money laundering because they allow illegal proceeds to be mixed with legitimate revenue, especially where cash sales are common and expenses are variable. Bars, restaurants, nightclubs, and similar businesses can make it difficult to reconcile actual customer activity with reported revenue and operating costs. This makes it easier to overstate revenues, inflate expenses, or insert illicit funds into the business records. Option A is inaccurate because money launderers might pay taxes on falsely reported income to make the funds appear legitimate. Option B is incorrect because a front may show high income despite low visible customer activity. Option C is too narrow and inaccurate because these businesses often involve variable purchases and pricing.
NEW QUESTION # 77
Aja is implementing measures to help ABC Company detect signs that its proprietary information has been stolen. Which of the following practices would be MOST HELPFUL for Aja to implement?
Answer: B
Explanation:
The best practice is to identify employees leaving the company who have downloaded an unusually large number of data files. Departing employees present a heightened risk of proprietary information theft because they might take customer lists, pricing data, product designs, research, formulas, source code, or strategic plans for use with a competitor or new venture. Monitoring abnormal downloading activity is a targeted detective control that focuses on actual access and extraction of sensitive data. Options A and C rely on external competitor activity and might reveal only indirect indicators after damage occurs. Option B is too broad because permitted access alone does not show theft. The ACFE material emphasizes insider threats, safeguarding proprietary information, and monitoring unusual access or transfer of sensitive data.
NEW QUESTION # 78
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