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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Identity Theft | 1–5% | - Types and techniques - Prevention and detection |
| Topic 2: Accounting Concepts | 5–10% | - Recording and summarizing transactions - Financial statements structure - Basic accounting principles - Internal control fundamentals |
| Topic 3: Industry-Specific Financial Crimes | 15–25% | - Real estate and securities fraud - Healthcare fraud - Financial institution fraud - Insurance fraud - Cyber-enabled and cryptocurrency fraud |
| Topic 4: Asset Misappropriation – Cash Disbursements | 10–15% | - Check and payment tampering - Billing schemes - Expense reimbursement schemes - Payroll schemes |
| Topic 5: Asset Misappropriation – Cash Receipts | 5–10% | - Prevention and detection methods - Cash larceny schemes - Cash skimming schemes |
| Topic 6: Corruption Schemes | 5–10% | - Illegal gratuities and extortion - Conflicts of interest - Bribery and kickbacks |
| Topic 7: Asset Misappropriation – Non-Cash Assets | 5–10% | - Concealment techniques - Misuse of assets - Inventory and equipment theft |
| Topic 8: Financial Statement Fraud | 10–15% | - Detection and red flags - Expense and liability understatements - Revenue and asset overstatements - Timing and disclosure manipulations |
| Topic 9: Theft of Data and Intellectual Property | 5–10% | - Safeguarding proprietary information - Data and IP theft methods - Corporate espionage |
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NEW QUESTION # 250
Which of the following is the criterion for bid solicitation?
Answer: B
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Fraudulent bid solicitation practices include issuing requests for proposals or bid documents that contain false statements or misleading conditions to favor a particular vendor.
* Analysis of Incorrect Options:
* B. Employment discussions - A conflict of interest, not bid solicitation fraud.
* C. Withdraw low bids - A submission phase scheme.
* D. Falsify bid log - A separate manipulation method, not solicitation criterion.
* Key Concept: Fraudulent bid solicitation - using false or misleading statements to limit competition.
Reference: ACFE Fraud Examiners Manual (2020 International Edition) , Corruption - Bid Solicitation Manipulation .
NEW QUESTION # 251
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 # 252
_____________ involves purposeful misreporting of financial information about the organization that is intended to mislead those who read it.
Answer: D
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Fraudulent financial statements (or "fraudulent statement") refer to the intentional misrepresentation of financial condition, typically through overstating revenues, understating expenses, inflating assets, or concealing liabilities. The intent is to mislead stakeholders such as investors, creditors, or regulators.
* Analysis of Incorrect Options:
* B. Corruption - Refers to abuses of influence and conflicts of interest, not misreporting financial information.
* C. Asset misappropriations - Involve theft of assets, not misrepresentation of reports.
* D. None of the above - Incorrect since option A is correct.
* Key Concept: Financial Statement Fraud - misrepresentation of organizational performance and position.
Reference: ACFE Fraud Examiners Manual (2020 International Edition) , Financial Statement Fraud section
- Definition and Types .
NEW QUESTION # 253
Which of the following statements is TRUE regarding income statements?
Answer: A
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: Gross profit = Net sales - Cost of Goods Sold (COGS). This is the correct definition, as per standard accounting principles.
* Analysis of Incorrect Options:
* A. Gross revenue - Defined as total sales before deductions, not after.
* B. Net profit - Net profit is after all expenses (operating, interest, taxes), not before.
* D. Operating expenses - Appear after gross profit, not at the top.
* Key Concept: Income statement structure and key definitions .
Reference: ACFE Fraud Examiners Manual (2020) , Accounting Concepts: Income Statement Analysis .
NEW QUESTION # 254
The essential elements of a ________ are an actual or constructive taking away of the goods or property of another without the consent and against the will of the owner and with a felonious intent.
Answer: A
Explanation:
Detailed Explanation:
* Rationale for Correct Answer: The correct answer is A. Larceny . As defined in the Fraud Examiners Manual (2020 International Edition) , larceny is the unlawful taking of another's property with intent to permanently deprive the owner of its use or possession. Essential elements include: (1) the wrongful taking or carrying away of property, (2) without the consent of the owner, and (3) with felonious intent (i.e., intent to steal). This aligns directly with the definition provided in the question.
* Analysis of Incorrect Options (Distractors):
* B. Abuse - Abuse typically refers to the improper use of authority or resources (e.g., excessive expense claims, misuse of assets), but it is not a legal term describing theft by taking.
* C. Fiduciary - Fiduciary describes a relationship of trust or duty to act for another's benefit, not the act of theft.
* D. None of the above - Incorrect because "larceny" precisely matches the elements described.
* Key Concept: The definition and elements of larceny , which is a foundational legal concept for distinguishing among asset misappropriation schemes such as larceny vs. skimming .
Reference: ACFE Fraud Examiners Manual (2020 International Edition) , Financial Transactions - Cash Receipts: Cash Larceny section, which explains the essential elements and characteristics of larceny schemes.
NEW QUESTION # 255
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