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| Section | Objectives |
|---|---|
| Topic 1: Financial Crimes | - Banking and Payment Fraud
|
| Topic 2: Fraud Schemes | - Financial Statement Fraud
|
| Topic 3: Fraud Investigation and Analysis | - Evidence collection and documentation
|
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NEW QUESTION # 189
Which of the following measures would be MOST EFFECTIVE in helping a financial institution prevent new account fraud?
Answer: D
Explanation:
The correct answer is C. New account fraud often involves opening accounts with false, stolen, or synthetic identities. The most effective preventive measure listed is to verify the customer's identity through reliable third-party credit reporting agencies and customer identification services. These sources can help confirm identity details, detect inconsistencies, identify suspicious histories, and reduce reliance on documents that might be forged. Employer recommendation letters are not standard or reliable identity controls. Small cash deposits are not automatically suspicious and might be normal for many customers. Sending communications to all previous residences is inefficient and unlikely to be the strongest verification method. The ACFE financial institution fraud materials identify new account fraud schemes and emphasize customer identification controls as a prevention method.
NEW QUESTION # 190
Which of the following reasons is an acceptable justification for departing from generally accepted accounting principles (GAAP)?
Answer: D
Explanation:
The correct answer is C. Under accounting concepts, the cost-benefit constraint recognizes that the expected benefits of financial reporting information should justify the expected costs of providing it. A departure from GAAP may be acceptable only in limited circumstances where compliance is impracticable or the cost of compliance exceeds the benefit, provided the departure is properly evaluated and disclosed under the applicable framework. Option A is insufficient because expense alone does not justify noncompliance unless the cost-benefit threshold is met. Option B is clearly improper because improving reported profitability is a fraudulent motive, not a valid accounting reason. Option D is also not a valid justification because growth or international expansion does not permit disregarding required accounting standards.
NEW QUESTION # 191
Otto, a bank manager, purchases a new boat that he cannot afford. Knowing that one of the bank customers is an older client who does not regularly check their account, Otto takes money from the customer's account to make his boat payments. To conceal the missing amount, Otto adjusts the bank's general ledger. Which of the following BEST describes Otto's scheme?
Answer: D
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Otto's act combines misappropriation of customer funds with concealment via false accounting entries . Per the Fraud Examiners Manual , concealment through altering records is a hallmark of accounting fraud schemes tied to asset misappropriation.
* Analysis of Incorrect Options:
* A - Unauthorized disbursement typically refers to fraudulent payments like check tampering, not customer withdrawals.
* B - Dormant account fraud targets unused/inactive accounts; the victim here is an active but inattentive customer.
* D - Unauthorized withdrawal is part of the theft, but the defining element is the falsified ledger concealment, making C more precise.
* Key Concept: Asset misappropriation with concealment through false accounting.
Reference: ACFE Manual, Asset Misappropriation - Concealment Methods .
NEW QUESTION # 192
__________ is required if and when officers, executives, or other persons in trusted positions become subjects of a criminal indictment.
Answer: C
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Disclosure is required whenever individuals in positions of trust are indicted or otherwise compromised. Transparency ensures stakeholders are aware of potential conflicts or risks.
* Analysis of Incorrect Options:
* A. Conflict of interest - A scheme, not the corrective measure.
* B. Turnaround sale or flip - Specific scheme, irrelevant here.
* D. Resource diversion - A fraud method, not a governance requirement.
* Key Concept: Importance of Disclosure in preventing or responding to conflicts of interest.
Reference: ACFE Fraud Examiners Manual (2020) , Corruption: Disclosure Requirements .
NEW QUESTION # 193
Which of the following scenarios is an example of upcoding ?
Answer: C
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 # 194
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