The Department of Social Services in the State of Missouri does not have much success even with the Sarbanes-Oxley Act of 2002 implemented. This act was put in place to reduce public fraud and in this organization; the fraud still seems to be increased. Although Medicaid Fraud and Compliance has been overwhelming even with preventative measures in place, an area that hits close to home for me is the amount of child care reimbursement fraud that exists within the state. In comparison, these two types of fraud are extensive and continue to occur at rapid pace within the State of Missouri. Medicaid Fraud and Compliance
For the purpose of preventing Medicaid fraud, the Department of Social Services has established a hotline that can be utilized for reporting fraud. In addition to the Sarbanes-Oxley Act of 2002, (Missouri Department of Social Services, 2014) the Social Security Act in accordance with the Affordable Care Act requires states to contract with a Recovery Audit Contract vendor and allows states to reimburse contractors who assist in the identification and recovery of improper payments. Furthermore, the Deficit Reduction Act of 2006, the Medicaid Integrity Program utilizes Medicaid Integrity Contractors (MICs) to analyze Medicaid claims data and to identify high-risk areas and potential vulnerabilities, as well as conduct post-payment audits.
The Essay on Blood Brothers: Act One on Social Class
Look again at the extract on page 24 starting with “Do you want to come and play?” and ending with “now you say after me: ‘I will always defend my brother’.” With reference to the ways Russell presents the theme of social class in the extract and elsewhere in the novel in act one, show how far you agree that there is no escape from the effects of social class for the characters in the play. Willy ...
Missouri’s MICs conduct audits of Missouri hospice providers. The MICs may request documentation that supports Medicaid-enrolled participants’ eligibility for hospice, and other documents to ensure proper billing. The Recovery Audit Contract vendor will be reviewing paid claims for proper billing, and to ensure the claims were not paid twice (duplicate billing) and that proper quantities were billed. Finally, they may request documentation to include items such as a copy of the original prescription, the dispensing record, documentation of offer to counsel, and the signed delivery record (Missouri Department of Social Services).
Child Care Fraud
Child care reimbursement fraud is continuing to grow in the State of Missouri. The Department of Social Services releases funds for parents that qualify for child care reimbursement. However, providers continue to bill social services for children that are not present on the days billed for, or they bill for children that are no longer enrolled at the facility. Following a report by Fox 2 News investigator, Chris Hayes (Fox 2 News, 2013), and a St. Louis city daycare being shut down for unsafe building conditions by the city building inspector; the Department of Social Services in conjunction with the Department of Health and Senior Services, Section for Child Care Regulation has determined that Kidz In Action Daycare has been committing fraud in access of several thousand dollars per months by claiming children that were not in attendance or no longer enrolled.
For clarification, the Section for Child Care Regulation was able to revoke the daycare license of the provider, however billing did not cease during the time the daycare was closed. With the help of The Department of Health and Senior Services, the Department of Social Services has launched their own investigation in child care fraud with the facility in an attempt to cease reimbursement. The Sarbanes-Oxley Act of 2002
The Homework on Latchkey Kids Children Parents Care
"Latchkey Kid" is a term that came into existence during World War II. It was used to describe the large number of youth who were left without direct adult supervision. During this period of time, most Americans were involved in the war effort. Many fathers were in military service and many mothers went to work outside of the home to support their families and help our country win the war. As a ...
Section 404 of the Sarbanes-Oxley Act of 2002 describes the compliance of regulatory requirements in preventing fraud within any type of organization. Reducing fraud requires companies to be more diligent in creating and maintaining internal controls and by forcing public company auditors to work harder. However, organizations with a market capital under $75 million were not required to comply with this section of the legislation. Therefore, according to an article describing the circumstances of saving cost (T. Coenen, 2010), exemption from this section was granted to smaller organizations. Documenting the internal controls process and having the company’s outside auditors examine those controls is extremely expensive, and was thought to be disproportionately expensive for smaller companies; thus the exemption was granted. There is an importance in knowing that “companies with dishonest or incompetent executives will have fraud problems no matter what the legislation says” (T. Coenen 2010).
Conclusion
Based on the information provided regarding the Sarbanes-Oxley Act of 2002, costs of auditing is expensive and is not completely effective in eliminating fraud. As depicted in the comparison of Medicare/Medicaid fraud and Child Care fraud, there remains a concern regarding the amount of fraud within the State of Missouri. The regulatory compliance for these types of fraud is continuing to fail. Additional implementation needs are necessary for reduction of fraud in all types. Organizations should continue their own internal controls and regulation standards for fraud prevention. The cost of auditing for fraud internally is notably much lower than outsourcing for fraud prevention. However the means, fraud reduction should be a priority for all types of organizations.
References
Coenen, Tracy. 2010. Fraud Files: How Well Does Sarbanes-Oxley Reduce Fraud Risk?
Retrieved from website: http://www.dailyfinance.com/2010/07/16/fraud-files-how-well-
does-sarbanes-oxley-reduce-fraud-risk/
Hayes, Chris. 2013. Fox 2 News Article: St. Louis City daycare shut down. Retrieved from
website: http://fox2now.com/2013/07/15/st-louis-city-daycare-shut-downed/ Missouri Department of Social Services. 2014. Update on Recovery Audit Contractor (RAC)
The Essay on Avoiding Future Frauds with the Sarbanes-Oxley Act
... Sarbanes-Oxley (SOX) act in 2002 was specific to reducing future financial fraud and imposing criminal penalties for publicly traded companies. ... same requirements. “Regulatory compliance opposes economic costs on organizations and can affect their competitive advantage” (Srinivasan, ... can be excessive for some smaller companies. Auditing expenses cause companies to seek private investment and become ...
and Medicaid Integrity Contractor (MIC) Activities. Retrieved from website:http://mmac.mo.gov/update-on-recovery-audit-contractor-rac-and-medicaid-integrity-
contractor-mic-activities/