Chapter 6
In This Chapter
Examining frauds committed by businesses against the public
Recognizing frauds committed against businesses
Focusing on frauds against the government
Getting acquainted with the Ponzi scheme
Everyone is affected by fraud, either directly or indirectly. Even if you haven't been a victim of fraud, you pay for it. Think about it: Does your credit card company really need to charge you 24 percent interest and all those big fees? It does so to make up for all the costs associated with phony credit cards, stolen credit cards, and customers who just don't pay.
This chapter introduces some of the most common types of fraud committed by businesses, against businesses, and against the government. The goal here isn't to give you all the details about every type of fraud imaginable. Instead, this chapter simply gets you thinking about what fraud often looks like so you have a sense of the scope of work an accountant may encounter when addressing possible fraud — the willful intent to deceive.
The goal of most businesses is to earn a profit. The more successful the business is, the bigger the profit it earns and the bigger the return on everyone's investment in the business. Sometimes the pressure to earn a profit drives business owners, executives, and managers to commit fraud. Business owners get greedy. Executives are driven to please the stockholders. And managers are eager to keep their jobs and earn bonuses and recognition from their superiors. All these motivations and more often tempt people in business to commit fraud. The following sections explain the types of fraud often committed by businesses and the people who operate those businesses.
Some businesses thrive by taking advantage of people who are weak or unknowledgeable. Here are just a few examples:
See the upcoming section “Dealing in subprime and predatory lending” for more detailed information about fraudulent mortgage practices.
Many elderly people are easily talked into signing documents they can't read or understand. The next thing you know, their savings and possibly even their home are gone. The American Association of Retired Persons (www.aarp.org) maintains a section on its website with the latest scams and frauds targeting the elderly. AARP also provides information on how not to become a victim of these frauds.
Would you like to make millions with only a small investment? Of course you would! Unfortunately, it rarely happens that way. Yet many people get at least three pieces in the mail every day promising riches from investing in gold, penny stocks, foreign stocks, systems for investing when the market is going up, systems for investing when the market is going down, distressed real estate, and so on. Invitations to free seminars or luncheons where someone will expound on the only proven system for getting rich are also plentiful. Besides the mailers, advertisements play on the radio, appear in newspapers, and pop up on websites. The only ones getting rich from these schemes are the promoters.
Although the investment schemes advertised in mailers and newspapers may seem easy to spot, other types of investment fraud are much less obvious to the general public. Some businesses use fraudulent methods to manipulate their own stock values (or the values of stocks they've invested in) and steer investor decisions in ways that benefit the business rather than the investor.
If you've ever watched TV or read a newspaper, you're likely familiar with the concept of greasing someone's palm in order to get special consideration. Why would a company resort to bribes to conduct business? Some bribes are relatively minor, such as when a company offers a bribe in order to speed up the processing of an application that would have been approved, anyway. Other bribes are much more serious, such as when a company offers a bribe to be allowed to create dangerous conditions for its employees or the public. For example, after several deadly crane collapses in New York City, the city's Department of Investigation launched probes into the crane business. It found that a large crane company had bribed inspectors from the Department of Buildings to falsify inspection reports. This bribery had deadly results.
Laundering money is a process used to make money earned illegally appear as though it was earned through legal business activities. Organized crime and drug traffickers often have a lot of cash money to launder by using methods such as these:
The U.S. government has enacted several laws to try to combat money laundering. For starters, any cash transaction over $10,000 must be reported to the Internal Revenue Service. If you get lucky in Las Vegas and cash in chips for $10,000 or more, the casino will ask you for your Social Security number and report the transaction. If you then walk over to a car dealer and pay for a car with $10,000 in cash, the car dealer will likewise ask for your Social Security number and prepare a report to the IRS.
If a bank suspects that someone's transactions are being broken up into amounts smaller than $10,000 to avoid the reporting, the bank will still make a report to the IRS. (However, if a business has routine bank deposits of $10,000 or more, it may request an exemption from the required filing.)
Also, transporting more than $10,000 in cash in or out of the United States without a customs declaration is illegal. Reporting requirements also exist for money transfers; money transfer agencies are required to report any money transfer of $3,000 or more.
Construction fraud usually occurs when a contractor doesn't complete a project according to the specifications of the contract, doesn't build according to the relevant building codes, or bills inappropriately. Here are some specific examples of construction fraud:
These two problems, related to mortgages, often go hand-in-hand:
Usually, the victims of subprime and predatory lending are desperate and/or lack financial sophistication. And usually, they don't have an accountant or attorney in the wings waiting to offer advice on whether a deal seems legitimate. The U.S. financial crisis that began in 2007 certainly shined a spotlight on these despicable practices, but that doesn't mean they're certain to end.
Many employers play by the rules, but some want to write their own rulebooks when it comes to what they expect from employees. How can they get away with treating employees unfairly? Especially when the economy is fragile, people earning paychecks don't want to rock the boat; they're too concerned about feeding their families.
Here are some of the most common rackets run by unethical employers:
Despite what you may be thinking, businesses aren't always on the giving end of fraud; sometimes they're on the receiving end. And they can get it from all sides: employees, customers, vendors, and the public. This all adds to the cost of doing business; some of those costs are explained in this section.
At some point, an employee has to be trusted. The trust may be as simple as access to the premises and a desk with supplies. It may be as important and complex as access to cash receipts, valuable inventory, formulas and trade secrets, or customers. An employee in a position of trust can easily commit asset misappropriation or embezzlement: the appropriation of entrusted assets for one's own use.
Asset misappropriation can be as simple as the employee using the copy machine for a personal copy or taking home office supplies. But it may also be as serious as diverting cash.
A company's customers and vendors can also be sources of fraudulent activity. A customer may open a credit line with no intention of paying. A vendor may take a deposit for an order and disappear.
To prevent being a victim, a company must check out who it's doing business with to make sure potential customers and vendors have a history of delivering as promised and making timely payments.
Many sources of information about businesses exist, including rating agencies such as Dun & Bradstreet and information services such as Mergent. If a company is too small to afford subscriptions to these services, some public libraries make them available. And some banks that subscribe to these databases may allow a business customer to look up a certain name.
Insurance fraud occurs when someone files a claim with an insurance company to get benefits that he's not entitled to — or when someone otherwise intentionally causes an insurance company to pay out money that shouldn't be paid out. The Coalition Against Insurance Fraud (www.insurancefraud.org) estimates that insurance fraud costs about $80 billion per year. And guess what? To stay in business, the insurance companies that face such daunting amounts of fraud spread the joy to all their customers in the form of higher insurance premiums.
Here are just a few examples of what insurance fraud can look like:
Leading up to the mortgage meltdown that started in 2007, banks and loan officers were certainly guilty of committing fraud against borrowers, but at the same time, many borrowers were ripping off the banks. Here are several common scams involving real estate and mortgage fraud:
The government is always a convenient target for fraud. Because government is big, bulky, and subject to political pressures, it has a hard time controlling frauds despite its many efforts. The ways to commit fraud against the government are countless. This section describes some of the most common frauds — and how the government's forensic accountants try to uncover them.
The more taxes that are imposed, the more people try to wriggle out of paying them. But the wriggling counts as tax fraud, and the consequences of getting caught can be severe. Title 26 of the Internal Revenue Code says that tax fraud is a felony, and anyone committing it may be subject to imprisonment, fines, or both.
Title 26 also provides some examples of tax fraud: Evading paying taxes (including estimated taxes), refusing to remit any taxes collected from other parties (such as withholding tax), signing a tax return that you know contains untrue information, intimidating a government employee who is enforcing the tax law . . . the list goes on.
For a while now, the U.S. Congress has not given the IRS sufficient funds to investigate and stop tax fraud. As a result, the IRS should be collecting a huge amount of money that it's not collecting. The difference between what's collected and what should be collected is called the tax gap. If the IRS were able to collect 100 percent of the tax due under the tax law, the country could see a rewrite of tax law to lower the rates or reduce deficit spending.
Someone is always coming up with a new way to evade taxes. Schemes range from deceptively simple to very complex. The IRS tries to stay one step ahead of the tax cheats, but usually is a few steps behind.
The IRS does have several tactics in its war against the cheats. Perhaps the most powerful is the dreaded tax audit. IRS auditors are, in essence, forensic accountants, and they do compliance auditing. The absolute best defense for an audit is to do the tax return correctly in the first place. If the return is correct, the audit is a mild pain that will go away. If the return is wrong, the IRS will collect the unpaid taxes along with any interest and penalties and, in extreme cases, refer the case to the criminal investigation division.
How does the IRS choose which returns to audit? Every few years, the IRS runs programs to determine where taxpayers are cheating the most. To do so, the IRS pulls returns randomly, conducts audits, and determines which kinds of errors and omissions are being seen the most. After completing this process, it has its computer system flag any returns that come in bearing the same signs as the faulty returns in the audit. The signs may include your occupation, the relationship of your mortgage interest deduction to your income, the number of children you're claiming, the relationship of your charitable giving to your income, and so on.
Of course, the IRS also audits returns based on information from whistleblowers, other auditors, and criminal investigations. If you know that someone is committing tax fraud, you can file form 3949-A with the IRS. The IRS will analyze your information, and if it conducts an audit and manages to collect money, you may be eligible for a cash reward (which is taxable income — what the IRS giveth, the IRS taketh away).
In the United States, the income of individuals and entities such as corporations is subject to tax (unless an exception applies to that individual or entity). That's why April 15 is such a banner day for accountants. For individuals, tax is computed based on gross income less certain adjustments and itemized deductions. For a business, tax is computed on revenues less ordinary and necessary expenses.
Businesses and individuals may commit income tax fraud in one or both of the following ways:
How can you avoid reporting income? If you have a business that collects cash from its customers, the cash can go directly in your pocket, and you just don't report the income. If you get checks, you could cash them at a compliant check-cashing agency or send them to a bank overseas. Trading valuable goods or services without reporting goods or services received is another form of tax fraud.
What about deducting too many expenses? Often, in closely held businesses, the owners charge personal expenses to the business. By doing so, they reduce the net income of the business and reduce their tax obligation. Ferreting out this type of fraud is rather easy: You examine the invoices for company expenses to determine the real recipient of the goods or services. For example, look at all the utility bills and find the address being serviced (which is shown right on the bill). Determine whether the address is a business site or the business owner's home. A small-business owner charged his toddler's daycare provider as a business consultant. The bills clearly indicated that he had committed tax fraud.
Sales tax is imposed on the purchase of certain goods and services. Sales tax exists in most states, but not all. Many local governments (counties and municipalities) also impose a sales tax. The Tax Foundation (www.taxfoundation.org) tracks sales tax percentages by state, which may vary widely among states.
Generally, sales tax is collected by the retailer from the purchaser at the time of purchase. Then, at a specified due date, the retailer remits the tax to the government. When sales tax isn't collected at the time of sale, in most cases the purchaser is responsible for paying the equivalent amount (to their state) in use tax.
Where does fraud come into play with sales tax? Sometimes a retailer collects the tax from its customers but doesn't remit it to the government. When this happens, usually the retailer is also neglecting to report all its income.
How can a business get caught skipping out on sales tax? In some cases, state auditors stand outside businesses and watch how many people go in and out and use the number to estimate sales. Some auditors use the gross percentage profit (GPP) method to estimate a company's sales amount, which involves comparing a company's percentage of profit to that same percentage in other companies in the same industry. (If the GPP of one company is much higher than the industry average, sales tax fraud is probably involved.) State and local governments are continually finding new and creative ways to pick up the underreporting of sales tax.
Remember, sales tax is a fiduciary tax: The business collects and holds the government's money. If the business doesn't remit the tax to the government, the government can and will go after the responsible parties personally. These people don't have the protection of a corporation for fiduciary taxes. In other words, officers in a corporation can be held personally liable for not remitting taxes due to a government entity.
In the section “Taking advantage of employees” earlier in the chapter, you read that some employers like to have employees accounted for as independent contractors. A principal reason for doing so is to save on the many employment taxes and other levies that an employer must pay, which can add up to quite a bit of money. These taxes and levies include:
Employment taxes can add up and put a significant dent in the bottom line of a business. But trying to pass off employees as individual contractors is risky business. Besides the IRS, other federal and state agencies (as well as private insurance companies) send auditors and forensic accountants to businesses to determine whether a company is classifying its employees correctly. If these auditors and forensic accountants determine that individual contractors should be classified as employees, the employers are on the hook for taxes and insurance premiums.
Transfer pricing is the price at which goods are exchanged between two separate accounting systems within the same holding company. Here's an example: Conglomerate, Inc.'s U.S. division buys widgets from Conglomerate's Martian division to put into a machine it assembles and sells in the United States. The transfer price is the price the U.S. division pays the Mars division.
Here's where the fraud comes in. Let's say the corporate tax rate on Mars is 15 percent, and the rate in the United States is 35 percent. If the transfer price is high, the Martian division makes more money and the U.S. division makes less money. For every dollar of profit transferred to Mars, Conglomerate saves 20 cents in tax. Artificially increasing the Martian price is a fraud. The IRS and the international conglomerates have forensic economists working to determine what a fair price is for the transfer of goods. For more information, take a look at www.transferpricing.com.
The earlier section “Perpetrating construction fraud” discusses the potential for fraud related to construction work. But the potential for contract fraud against the government extends way beyond construction because the government hires contractors for just about everything: military research, medical research, hospital management, school management, prison management, and on and on. In any of these contract situations, the potential for fraud exists:
Here's just one example: Stanford University was accused of charging flowers for the home of the university president to a defense contract. The instant this accusation hit the news, every university in the country that had a defense contract initiated examinations to see whether anything was charged to government contracts that shouldn't have been. After a thorough forensic examination by the Office of Naval Research, Stanford paid the government $1.2 million for improper expensing from 1981–1992.
Any entity with government grants or contracts is subject to being audited by government examiners. These examiners look at accounting records as well as production or usage records.
Medicare is a federally sponsored and managed program (funded partially by the federal government and partially by the states) that provides medical care for the elderly and recipients of Social Security disability payments. Medicaid provides medical care for the poor. Both programs are at a high risk for potential fraud.
Many of the frauds occur when so-called healthcare providers bill for services not rendered. For example, Florida has ongoing investigations of sham healthcare supplies providers. Here's how it works: A sham operation opens up in a storefront and somehow gets lists of seniors and their Medicare billing information. Then the fraudsters bill the Medicare program for wheelchairs, walkers, and other items that the patients’ doctors never ordered and the patients never received. Unfortunately, many times these guys close up shop and move on before the investigators arrive at their door.
Sometimes doctors and clinics bill for procedures they never performed. To combat this type of fraud, Medicare and Medicaid computers are programmed to look for excessive billing by providers. If the average clinic doctor sees 25 to 40 patients during an eight-hour day, and a certain doctor bills for 80 to 120 patients per day, alarm bells ring.
The Medicare and Medicaid computer programs also look for hysterectomies performed on men (yes, fraudsters are stupid enough to bill for this) and treatments for organs that have previously been removed (having more than one appendix is rare).
On the recipient side are many stories of fraud in the Medicaid program. For example, someone may not qualify for Medicaid but “rents” a Medicaid card when she needs to go to the doctor. She may pay a certain amount to use the card for a single doctor's visit or a higher amount to keep the card for a whole day.
Some people lie about their financial condition so they can get Medicaid benefits. Unfortunately, many local Medicaid offices are underfunded and too swamped to check out applicants thoroughly.
Social Security is a federal benefits program started during the Great Depression that provides benefits for retirees, widows and widowers, orphans, and people unable to work because of permanent disability. Eligibility and benefit amounts are complicated, and you can find more information at www.ssa.gov. The Social Security Administration (SSA) also administers the Medicare program.
Whenever the government distributes money, fraudsters line up to collect their share. Some of the common types of Social Security fraud are:
The fraudsters accomplish their deceits in a wide variety of ways, including:
The SSA relies on IRS agents to report possible frauds they find while they're performing audits. It also relies heavily on the public to report suspected fraud.
This type of fraud deserves a section all its own. In a Ponzi scheme, a fraudster steals money to create the illusion of being legitimate so he can continue to steal money. The Bernie Madoff fraud that shocked the world in 2008 is probably the best-known example.
Here's how a simple Ponzi scheme works: Mr. Fraud needs money. He approaches Allison and says that he can invest her money and earn her an interest rate of 10 percent. Allison believes him and gives him $100. Mr. Fraud doesn't really invest Allison's money; he spends it. But he needs to give Allison her interest, so he approaches Billy with the same deal. Billy believes him and gives him $200. Mr. Fraud puts $10 in Allison's account (representing her interest on $100) and the remaining $190 in his pocket.
When the time comes for Mr. Fraud to give both Allison and Billy their interest, he approaches Charlie with the same deal. Mr. Fraud convinces Charlie to invest $300. He puts $10 in Allison's account and $20 in Billy's account to cover the interest. He puts $270 in his own pocket.
Uh oh, now Billy wants to withdraw money. Mr. Fraud finds Diana and convinces her to invest money. Diana gives him $400, part of which Mr. Fraud uses to put Billy's principal back in his account.
You get the picture. The Ponzi schemer keeps up an elaborate scheme of borrowing from Peter to pay Paul. At some point it gets too big to handle; the schemer just can't find enough new investors to pay off the old. When that happens, the house of cards comes tumbling down.
Early reports on the Madoff scheme indicated that Bernie actually started off as an honest financial advisor. When the market got a little bit soft, he started doing the Ponzi thing so that his investors would continue to get high returns. However, even when the market rebounded he couldn't earn enough money to make up for the money he had borrowed, so he kept the Ponzi scheme going. When the market took big hits in 2008 and investors needed to get their money out to cover their cash shortfalls, Madoff couldn't keep up anymore, and it all fell apart.
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