This article is in the May/June 2003 issue of
The White Paper, the Journal of the Association of Certified Fraud Examiners.
 

Fraud In Other Words: Professional Jargon and Uncensored Street Slang
By Larry C. Adams, CFE, CPA, CIA, CISA
 

Bill-and-Run
 The sole object of this high-stakes game is for fraudulent medical vendors to invoice the Medi-Cal system for as much money as they can and then disappear to a new location before the State of California catches them. Once the State begins questioning invoices and billing patterns and withholds payments, the providers vanish with disconnected telephones, no forwarding addresses, and no evidence that the businesses ever existed. The Controller’s Office disallowed more than $17 million in payments in five months and demanded repayment from 25 vendors. Another $48 million was saved due to ceased billing activity. The fraudulent providers are playing the odds that they won’t get caught, and even if they do they simply reimburse Medi-Cal and consider previously ill-gotten payments as short term loans. Sometimes a fraudulent operation is sold to another individual. The new owner continues the same billing scheme with unsupported claims. They collude the same accountant, supplier, and referring physicians. To deter bill-and-run schemes, Medi-Cal now has the authority to pre-screen providers and to impose bonding requirements to recover funds from vanishing vendors.
“State Controller Targets ‘Vanishing’ Medi-Cal Vendors,” PRNewswire, AOL News, Nov. 3, 1999.
 

Clean Sheeting
A fraudulent practice of obtaining life insurance policies while hiding the terminal medical conditions of the applicants from the insurance company. To sell more policies and earn commissions, some insurance agents encourage customers to leave the answers to health questions completely blank. The completed applications are clean sheets - they have no red flag answers to the questions that could trigger denials of coverage.
“Viatical Fraud Claimed,” Times-Union.com, http://www.fraudnews.com/
ItemView.cfm?id=1012, Feb. 8, 2000.
 

Fall Money
Money put aside by a criminal for use if he should be arrested (take the fall). The money is intended as his hidden reward or a fund to pay his legal fees and bail bond.
John Ayto, Oxford Dictionary of Slang, Oxford University Press, Oxford, 1998, p. 182.
 

Good Cop, Bad Cop
A method designed to wear down an opponent by alternating a kind, compassionate approach with a harsh, unrelenting attitude. The expression comes from police interrogation techniques, in which one police officer assumes a hostile manner while a second officer disarms the subject with sympathy.
Elizabeth Webber and Mike Feinsilber, Merriam-Webster’s Dictionary of Allusions, Merriam-Webster, Incorporated, Springfield, Massachusetts, 1999, p. 232.
 

Money is the Root of All Evil
A theory that greed leads people to crime or trickery. The apostle Paul said, “the love of money is the root of all evil,” in I Timothy 6:10. George Bernard Shaw, an Irish-born playwright and social critic, offered a counter theory that the, “lack of money is the root of all evil,” in Maxims for Revolutionists.
James Rogers, Dictionary of Clichés, Ballantine Books, New York, 1985, p. 204.
 

Outside Man
The member of a group of con artists who gains the confidence of the victim prior to the con.
Jay Robert Nash, Dictionary of Crime, Paragon House, New York, 1992, p. 263.
 

Payola
A bribe or other secret payment of cash or gifts to induce someone to use his or her influence, position, or facilities to promote a commercial product. “Payola” is a contraction of the words “pay” and “Victrola” (a unique phonograph player first marketed in 1906). A U.S. Senate subcommittee began investigating payola within the music business in 1959. The subcommittee looked at an aspect of commercial bribery involving rock and roll disk jockeys who took gifts from record companies in return for playing their records on their radio and television shows. Twenty-five deejays and program directors including Alan Freed and Dick Clark were caught in the scandal. Other complaints were filed against record manufacturers and distributors. Stricter payola statutes subsequently were passed. In the late 1990s, similar “software payola” complaints were made against computer software developers paying retailers for favoring their software products and providing good shelf space. In 1997 in Virginia, legislators rejected a “pharmaceutical payola” bill that would have made it illegal for pharmacists to accept financial incentives for encouraging doctors to switch their patients’ prescriptions.
http://www.history-of-rock.com/payola.htm, Feb. 22, 2000.
 

Weight Loss Fraud
 Fraudulent weight loss products and programs often rely on unscrupulous but persuasive combinations of message, program, ingredients, mystique and delivery systems. They bilk Americans out of $10 to $40 billion each year. They imply large, fast weight loss without restricting calories, without exercising, and without a medical exam. The ads rely heavily on undocumented case histories and before-and-after photos, which do not mirror normal results. The programs promote diet pills, food supplements, creams, and gadgets like electronic stimulators, vacuum pants, and earrings. The products make claims about ingredients that are not allowed by the Food and Drug Administration. The promotions rely on a guru figure with secret answers unknown by others, and declare the established medical community is against the discovery and refuses to accept its miraculous benefits. High pressure sales tactics, infomercials, and one-time-only deals sell the products to a wide market. The con artists exploit children, teens, and low income consumers with their pseudoscience.
Francis M. Berg, “How to Identify Weight Loss Fraud,” http://www.healthyweightnetwork.com/
fraud.htm, Feb. 8, 2000.
 

ã Copyright 2002 Larry C. Adams.
All rights reserved.

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