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Some have estimated that healthcare fraud in the United States
results in losses of approximately $80 billion a year. Although
there are many books available that describe how to "detect"
healthcare fraud, few address what must be done after the fraud is
detected. Filling this need, Charles Piper's Healthcare Fraud
Investigation Guidebook details not only how to detect healthcare
fraud, but also how to "investigate" and prove the wrongdoing to
increase the likelihood of successful prosecution in court.The book
starts by covering the history of healthcare insurance and the
various types of fraud schemes. It presents Charles Piper's unique
approach to investigating (The Piper Method) which allows readers
to conduct as many as 10 simultaneous investigations for each case.
It emphasizes the importance of simultaneously searching for waste
and abuse as well as systemic weaknesses and deficiencies that
caused or contributed to the problem or wrongdoing under
investigation and then make recommendations for improvement. It
also provides: Questions to ask whistleblowers, complainants,
employers, employees, and healthcare providers who are suspects
Tips on investigative case planning, goals, and strategies Sample
visual aids for use when briefing others about your investigative
findings Guidance on presenting information obtained from
healthcare investigations and on how to testify in court Techniques
for uncovering previously undetected fraud The book includes a
sample case study that walks readers through a mock case from the
time the case is received through the end. The case study
demonstrates how to initiate, plan, and conduct a thorough and
complete healthcare fraud investigation while incorporating Piper's
proven methodology.Sharing insights gained through Charles Piper's
decades of experience as a federal special agent and certified
fraud examiner, th
Some have estimated that healthcare fraud in the United States
results in losses of approximately $80 billion a year. Although
there are many books available that describe how to "detect"
healthcare fraud, few address what must be done after the fraud is
detected. Filling this need, Charles Piper's Healthcare Fraud
Investigation Guidebook details not only how to detect healthcare
fraud, but also how to "investigate" and prove the wrongdoing to
increase the likelihood of successful prosecution in court. The
book starts by covering the history of healthcare insurance and the
various types of fraud schemes. It presents Charles Piper's unique
approach to investigating (The Piper Method) which allows readers
to conduct as many as 10 simultaneous investigations for each case.
It emphasizes the importance of simultaneously searching for waste
and abuse as well as systemic weaknesses and deficiencies that
caused or contributed to the problem or wrongdoing under
investigation and then make recommendations for improvement. It
also provides: Questions to ask whistleblowers, complainants,
employers, employees, and healthcare providers who are suspects
Tips on investigative case planning, goals, and strategies Sample
visual aids for use when briefing others about your investigative
findings Guidance on presenting information obtained from
healthcare investigations and on how to testify in court Techniques
for uncovering previously undetected fraud The book includes a
sample case study that walks readers through a mock case-from the
time the case is received through the end. The case study
demonstrates how to initiate, plan, and conduct a thorough and
complete healthcare fraud investigation while incorporating Piper's
proven methodology. Sharing insights gained through Charles Piper's
decades of experience as a federal special agent and certified
fraud examiner, the Healthcare Fraud Investigation Guidebook aims
to revolutionize the way that healthcare fraud investigations are
conducted. It provides the understanding you need to not only put a
bandage on the problem of healthcare fraud, but to actually start
curing the greed that is poisoning the healthcare industry.
Contract and procurement fraud, collusion, and corruption are
worldwide problems. Such wrongdoing causes federal, state, and
local governments, as well as private-sector corporations and
businesses, to lose funds and profits, while the wrongdoers
unjustly benefit. Bid riggers conspire to eliminate fair and open
competition and unjustly increase prices, allowing some to
monopolize industries. Too often, contracting officials and others
responsible for placing orders or awarding contracts compromise
their integrity and eliminate fair and open competition to favor
vendors offering bribes or gifts. This results in unfair playing
fields for vendors and causes financial losses for businesses,
government agencies, and taxpayers. Charles Piper's Contract and
Procurement Fraud and Corruption Investigation Guidebook educates
readers on fraud and corruption schemes that occur before, during,
and after contracts are awarded. This book teaches not only how to
identify such wrongdoing, but also how to investigate it and
prevent reoccurrence. Piper shares the Piper Method of Conducting
Thorough and Complete Investigations, his innovative and proven
method of investigating contract and procurement fraud, and
demonstrates its principles with personal, on-the-job examples
(which he calls "War Stories") woven throughout the text. Intended
for criminal justice students, as well as investigators, auditors,
examiners, business owners, policy-makers, and other professionals
potentially affected by fraud, this book is a must-read guide to
effective procurement and contract fraud investigations from
inception to testimony.
Contract and procurement fraud, collusion, and corruption are
worldwide problems. Such wrongdoing causes federal, state, and
local governments, as well as private-sector corporations and
businesses, to lose funds and profits, while the wrongdoers
unjustly benefit. Bid riggers conspire to eliminate fair and open
competition and unjustly increase prices, allowing some to
monopolize industries. Too often, contracting officials and others
responsible for placing orders or awarding contracts compromise
their integrity and eliminate fair and open competition to favor
vendors offering bribes or gifts. This results in unfair playing
fields for vendors and causes financial losses for businesses,
government agencies, and taxpayers. Charles Piper's Contract and
Procurement Fraud and Corruption Investigation Guidebook educates
readers on fraud and corruption schemes that occur before, during,
and after contracts are awarded. This book teaches not only how to
identify such wrongdoing, but also how to investigate it and
prevent reoccurrence. Piper shares the Piper Method of Conducting
Thorough and Complete Investigations, his innovative and proven
method of investigating contract and procurement fraud, and
demonstrates its principles with personal, on-the-job examples
(which he calls "War Stories") woven throughout the text. Intended
for criminal justice students, as well as investigators, auditors,
examiners, business owners, policy-makers, and other professionals
potentially affected by fraud, this book is a must-read guide to
effective procurement and contract fraud investigations from
inception to testimony.
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