Fraud is continuing to increase this year, in part due to the COVID-19 pandemic, according to a new survey by the Association of Certified Fraud Examiners.
The report found that 79 percent of anti-fraud professionals have seen an increase in the overall level of fraud as of November, compared to 77 percent in August and 68 percent in May. Thirty-eight percent of the respondents said in November the increase has been significant, compared to 34 percent in August and 25 percent in May.
Patty Starr is president and CEO of Health Action Council and is responsible for driving the strategic direction of the organization--build stronger, healthier communities where business can thrive.
Since joining the Health Action Council staff in 2013, she has transformed the organization yielding broad national expansion and seven consecutive years of
growth. Patty is a member of the Advisory Board at the Heritage College of Osteopathic Medicine and the Board of Directors for Health Policy Institute of Ohio (HPIO). She has also served on the Board of Directors for the Better Health Partnership, Ohio Patient-Centered Primary Care Collaborative and Health Action Council before becoming executive director in 2013.
Craig Kurtzweil is the chief data & analytics officer for UnitedHealthcare's commercial business. In this role, he leverages the nation's largest health care data set to identify and share insights that can help people and care providers make more informed health care decisions, make health care more affordable for everyone and improve outcomes. This includes exploring new ways to apply data through machine learning and artificial intelligence, creating the next generation of health care analytics and making data a differentiator in the marketplace for the company.
Craig joined UnitedHealthcare in 2005. Since then, he has focused on enhancing how data and analytics support UnitedHealthcare's largest employer customers. His team works with large and complex clients that require a broad view of data, ranging from cost and utilization to productivity and disability exposure. As part of this work, Craig formed the Center for Advanced Analytics to focus on analytic innovations that change the way we evaluate health care value.
Prior to joining UnitedHealthcare, Craig served as an actuarial consultant at Deloitte.
Cyber fraud, payment fraud (such as schemes with debit and credit cards) and identity theft are the three top fraud schemes seeing increases, according to anti-fraud professionals.
The largest increase in observed fraud was in financial statement fraud, with 7 percent more anti-fraud professionals reported seeing financial statement fraud in November, compared to August. That could be because as companies continue to see their profits drop, they feel more pressure to cook the books.
The survey also found 77 percent of anti-fraud professionals report that investigating and preventing fraud is more challenging now, while 71 percent said detecting fraud is more challenging as a result of the pandemic.
ACFE members anticipate the fraud trend will continue, even as vaccines have begun rolling out this week in the U.S. Ninety percent of the survey respondents expect a further increase in the level of fraud over the next 12 months, with 44 percent predicting the change is likely to be significant.
Nearly half (48 percent) of the organizations polled expect to increase their investments in anti-fraud technology, and 38 percent intend to raise the use of fraud-related consultants or other external resources. Budgets for anti-fraud training and professional development are experiencing a similar increase (according to 37 percent of the organizations polled), but nearly one-quarter (24 percent) anticipate a decrease in this area. The budget component most likely to see decreases is travel for anti-fraud staff, which shouldn’t be surprising given the plunging levels of air travel in general over this past year, with 38 percent of the survey respondents expecting a reduction in funds for travel in the year ahead.
