Posted by Ovais Ahmed.

An article posted on bloomberg.com talks about an appeal made by ex-Goldman Sachs trader Deeb Salem to get an extra $5 million he thinks he deserves in bonus money. He has already received $8.25 million and still wants to get more money out of his former company. I don’t understand why the trader can’t settle with the money he has already made, which is more than the average American would probably ever make. To me, it spells out nothing but greed. Salem states he helped Goldman Sachs earn $7 billion in profit and was sought after by many investment professionals in his industry. The article states:

In September, Justice Eileen Bransten denied Salem’s request to set aside a Financial Industry Regulatory Authority panel decision to dismiss his claim, and granted Goldman Sachs’s request to seal portions of the dispute with the former trader. Salem told a state appeals court in Manhattan today that the judge erred in her decision, according to a filing. Salem claimed he helped the bank earn more than $7 billion, and told the arbitration panel Feb. 25 that he was one of the most sought-after investment professionals in the mortgage industry. The panel, described by Salem’s lawyer as a ‘kangaroo court,’ didn’t let Salem call some of Goldman Sachs (GS)’ top trading executives as witnesses, resulting in a miscarriage of justice, according to his original petition.

Goldman Sachs claimed they gave Salem the opportunity to give his evidence, and followed through fully with the law in denying his award claim. Therefore, Salem has appealed the decision is continues his fight for the extra $5 million he believes he deserves due to his efforts at Goldman Sachs.

Ovais is a business administration major with a concentration in management at Montclair State University, Class of 2015.

Posted by Ovais Ahmed.

An article posted by the Wall Street Journal talks about the time it takes for high courts to actually hear a case. The average time runs around 6 years, and since 2009 that time period has been extended. There has been a case involving two businesses that are battling about who gets trademarks rights to screws they use. The article states,

The Supreme Court on Tuesday will consider a business battle over trademark rights for screws that has been in the courts for more than 16 years, an extreme example of how cases headed for the high court can be matters of endurance. . . . The average age for a high court case is nearly six years, but 37% of cases have taken longer since 2009. In most circumstances a case can spend at least three to four years in the courts before resulting in a high-court ruling.

The process to get a case heard at the high court is a true test of endurance, and the willingness to wait the time period in order to get the issue resolved in these courts.

The cost of legal fees overtime can add up to high numbers, and is one of the reasons people involved in the case can get emotional. The article states, “ Given the time and money litigants put into cases, emotions can run high by the time the Supreme Court gets involved. That is true in the long-running trademark case before the court this week.” There isn’t a specific reason that cases take so long to be heard in the Supreme Court, but it’s just that some rulings for appeals happen to take a while. Criminal cases are considered more important, and so if a civil case arises during the same time as a criminal matter, the civil case will have to wait.

The Supreme Court only sits 9 times out of the year, and if a case lands on the right timing of when the court sits, that case is likely to be heard quicker than if it landed during off season. If one needs a case to be heard in Supreme Court, I suggest he or she has the time, money, and endurance to wait his or her turn.

Ovais is a business administration major with a concentration in management at Montclair State University, Class of 2015.

Posted by Devaki Sidhaye.

Recently department of Justice announced largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 individuals, including 115 doctors, nurses and other licensed medical professionals. Their involvement in health care fraud scams totaling approximately $1.3 billion in false billings. As per the department, many of the charges were related to medical professionals illegally prescribing opioids and other prescription narcotics, some of which were then sold on the street. Furthermore, according to federal officials, a rehab facility in Palm Beach, Fla., recruited addicts with gift cards, drugs and visits to strip clubs, billed the government for over $58 million in false treatments and tests. A clinic in Houston allegedly gave out prescriptions for cash. Some falsely billed Medicare and Medicaid. Narcotics officers have arrested schoolteachers, doctors, nurses and fellow law enforcement personnel (Merle, 2017).

According to the Centers for Disease Control and Prevention, approximately 91 Americans die every day of an opioid related overdose. Attorney General Jeff Sessions said at a news conference that, “One American dies of a drug overdose every 11 minutes and more than 2 million Americans are ensnared in addiction to prescription painkillers.” He further said in assurance that, “We will continue to find, arrest, prosecute, convict and incarcerate fraudsters and drug dealers wherever they are.” Health and Human Services Inspector General Daniel Levinson added that, “Health care fraud is a reprehensible crime, it not only represents a theft from taxpayers who fund these vital programs, but impacts the millions of Americans who rely on Medicare and Medicaid” (Merle, 2017).

This approaches a larger debate about how the country should address the government estimates are addicted to opioids. Public health authorities urge doctors to cut back on the prescriptions they offer. States struggling with the shortage of treatment has proposed roll back of the Affordable Care Act’s expansion of Medicaid (Merle, 2017).

This crisis represents a massive public health challenge that requires a broad-based, multi-pronged response from public health agencies and law enforcement. Physicians, pharmacists and citizens all can play a role in identifying and preventing nonmedical use of prescription drugs. Doctors and other healthcare professionals who prescribe these drugs need to be educated about responsible prescribing of opioids and about safe, effective alternatives that are not addictive and presently available (Young, 2016).

Even though law enforcement officials use advanced investigative methods to uncover the different actions health care fraud happens, they can’t fight these crimes alone. Individual can help remove these people responsible for wrongdoings by protecting their health insurance identification number, social security number, looking through the statements for medical services he didn’t receive, and reporting to authorities on recognizing the signs of possible fraud (Outreach, 2012).

For the protection of each person of the country as well as for the economic strength it is essential to destroy all traces of health care fraud. Health care frauds damage billions of dollars of the nation; mislead general public in the courses of actions, and innocent people become victims of white-collar crime.

Devaki is an MS Accounting student at the Feliciano School of Business, Montclair State University, Class of 2018.

References:

Merle, S. H. (2017, 07 13). DOJ announces charges against 400 people for $1.3 billion in health-care fraud. Retrieved from www.washingtonpost.com: https://www.washingtonpost.com/news/business/wp/2017/07/13/doj-announces-charges-against-400-people-for-1-3-billion-in-health-care-fraud/?utm_term=.f9b959fbfea6

Outreach, E. &. (2012, 04 23). How to Protect Yourself From Health Care Scams. Retrieved from www.aarp.org: http://www.aarp.org/health/medicare-insurance/info-10-2010/fightfraud.html

Young, L. (2016, 03 04). There’s no debate – America’s opioid epidemic is undeniable. Retrieved from www.pennlive.com: http://www.pennlive.com/opinion/2017/09/heres_what_you_need_to_know_ab_5.html

Posted by Stephen D’Angelo.

Just six hours after New York Attorney General placed a temporary injunction, which would stop sites like Fanduel and DraftKings from doing business in New York, an appellate court saved them by issuing an emergency temporary stay that will allow New Yorkers to continue to use Fanduel and Draft Kings until further notice. This stay will last at least till the end of the year which is likely when a permanent decision will be made, “Eventually, both sides will go before a panel of four or five appellate judges” Randy Mastro said, from an outside council for DraftKings.

The State of New York is likely to win the case because of the wording of their law on gambling. Fantasy football gambling sites commonly use the defense that they don’t take wagers, they take entry fees. In many states, this allows them to continue to do business. But, New York is stating that their penal law does not refer to “wagering” or “betting.” Instead it states that a person, “risks something of value.”

Although New York has the upper hand, the laws in place are very vague. The statement regarding risking something of value had no relation to online fantasy sports gambling when created. It was worded this general because that would include gambling bookies in a gambling law. I personally do not believe that Fantasy sports gambling will be shut down in New York. The NBA, NHL, and MLB all own equity in Fanduel and the likelihood of the 600,000 New Yorkers who play daily fantasy to not be able to in the New Year is very slim.

Stephen is an accounting major at the Feliciano School of Business, Montclair State University, Class of 2017.

Posted by Devaki Sidhaye.

Recently department of Justice announced largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 individuals, including 115 doctors, nurses and other licensed medical professionals. Their involvement in health care fraud scams totaling approximately $1.3 billion in false billings. As per the department, many of the charges were related to medical professionals illegally prescribing opioids and other prescription narcotics, some of which were then sold on the street. Furthermore, according to federal officials, a rehab facility in Palm Beach, Fla., recruited addicts with gift cards, drugs and visits to strip clubs, billed the government for over $58 million in false treatments and tests. A clinic in Houston allegedly gave out prescriptions for cash. Some falsely billed Medicare and Medicaid. Narcotics officers have arrested schoolteachers, doctors, nurses and fellow law enforcement personnel (Merle, 2017).

According to the Centers for Disease Control and Prevention, approximately 91 Americans die every day of an opioid related overdose. Attorney General Jeff Sessions said at a news conference that, “One American dies of a drug overdose every 11 minutes and more than 2 million Americans are ensnared in addiction to prescription painkillers.” He further said in assurance that, “We will continue to find, arrest, prosecute, convict and incarcerate fraudsters and drug dealers wherever they are.” Health and Human Services Inspector General Daniel Levinson added that, “Health care fraud is a reprehensible crime, it not only represents a theft from taxpayers who fund these vital programs, but impacts the millions of Americans who rely on Medicare and Medicaid” (Merle, 2017).

This approaches a larger debate about how the country should address the government estimates are addicted to opioids. Public health authorities urge doctors to cut back on the prescriptions they offer. States struggling with the shortage of treatment has proposed roll back of the Affordable Care Act’s expansion of Medicaid (Merle, 2017).

This crisis represents a massive public health challenge that requires a broad-based, multi-pronged response from public health agencies and law enforcement. Physicians, pharmacists and citizens all can play a role in identifying and preventing nonmedical use of prescription drugs. Doctors and other healthcare professionals who prescribe these drugs need to be educated about responsible prescribing of opioids and about safe, effective alternatives that are not addictive and presently available (Young, 2016).

Even though law enforcement officials use advanced investigative methods to uncover the different actions health care fraud happens, they can’t fight these crimes alone. Individual can help remove these people responsible for wrongdoings by protecting their health insurance identification number, social security number, looking through the statements for medical services he didn’t receive, and reporting to authorities on recognizing the signs of possible fraud (Outreach, 2012).

For the protection of each person of the country as well as for the economic strength it is essential to destroy all traces of health care fraud. Health care frauds damage billions of dollars of the nation; mislead general public in the courses of actions, and innocent people become victims of white-collar crime.

Devaki is an MS Accounting student at the Feliciano School of Business, Montclair State University, Class of 2018.

References:

Merle, S. H. (2017, 07 13). DOJ announces charges against 400 people for $1.3 billion in health-care fraud. Retrieved from www.washingtonpost.com: https://www.washingtonpost.com/news/business/wp/2017/07/13/doj-announces-charges-against-400-people-for-1-3-billion-in-health-care-fraud/?utm_term=.f9b959fbfea6

Outreach, E. &. (2012, 04 23). How to Protect Yourself From Health Care Scams. Retrieved from www.aarp.org: http://www.aarp.org/health/medicare-insurance/info-10-2010/fightfraud.html

Young, L. (2016, 03 04). There’s no debate – America’s opioid epidemic is undeniable. Retrieved from www.pennlive.com: http://www.pennlive.com/opinion/2017/09/heres_what_you_need_to_know_ab_5.html

Posted by Stephen D’Angelo.

Friday morning, two days after the judge presiding the Uber class action lawsuit decided that drivers attempting to arbitrate can be included in the law suit, Uber sent drivers a new agreement. The document undermined the judge’s ruling by revising the arbitration clause.

Liss-Riordan and her team are filing an emergency motion that will be heard in front of Judge Edward Chen next Thursday; it asks the court to block Uber from enforcing this new driver agreement. “Uber has tried to fix the problem that Judge Chen ruled made the agreement unenforceable,” Liss Riordan told TechCrunch in an email.. The Private Attorney General Act gives “a private citizen the right to pursue fines that would normally only be available to the State of California. It also allows that private citizen to “seek civil penalties not only for violations that he personally suffered” but also for violations of “other current or former employees.”

According to Chen’s Wednesday ruling, the Uber driver agreement of 2014 and 2015 illegally waived drivers’ rights under PAGA, which informed Judge Chen’s decision that the arbitration clause could not be honored because it contained an illegal provision. This was the reason for the provision of the agreement, to quickly remove the illegality and include new provisions to the agreement.

The Private Attorney General Act protects uber drivers from what uber has tried to prevent, a large action against the company. Uber has agreed to resolve any claim against the company but only on an individual basis. Uber’s driver agreement provision also attempts to prevent workers from participating in any class collective or representative action against the company. Uber also rewrote the agreement to remove a requirement that arbitration between a driver and the company remain confidential. The language makes it clear that the agreement goes into effect only when a driver accepts it  not when a revision is published, therefore, protecting drivers who previously signed the agreement.

Stephen is an accounting major at the Feliciano School of Business, Montclair State University, Class of 2017.

Posted by Ali Paladino.

Recently, on September 1, 2016, the electric car maker Tesla Motors was called out for attempting to sell their vehicles directly to their customers in Missouri. The judge ruled Tesla’s efforts to rule out the middleman, car dealerships, violated state law.  The Missouri Revenue Department “gave the California-based manufacturer a license for a University City dealership in 2013 and a franchise license for a Kansas City dealership in 2014.” Both of these licenses allowed Tesla motors to sell their vehicles directly to their customers, disregarding any use of dealerships.

The court ruled this was not suitable, and Missouri Automobile Dealers Association agreed. The Association sued the State claiming that “it had given Tesla special privileges,” in their attempts to disregard using franchised dealerships to sell their vehicles. The court ruled that Tesla’s action was not technically unconstitutional, but held the licensing was not allowed. Tesla argued the ruling against them was going to damage the company and suppress their ability to compete with other motor vehicle companies. The company also argued the order was an “attempt” to “limit consumer choice in Missouri.” Yet, Tesla appears to be determined to try and continue to sell to their customers directly in the hopes that this will improve their bottom-line. Doug Smith, head of the Dealers Association, however, does not agree with Tesla’s actions and believes that it is not fair to other manufacturers. He believes all manufacturers should be “treated the same in Missouri.”

I have to agree with Doug Smith. I do not think Tesla should have the right to sell directly to their customers and completely bypassing dealerships, only because it puts the company on a different playing field than other motor vehicle companies. I do not believe that is fair.

Tesla has looked at other ways to get around laws in other states in order to improve their sales; however, I do not agree with this either. In this situation, the law stands blurry and unclear and it is intriguing to see how far Tesla will go in attempts to get around the law.

Ali is a finance major at the Stillman School of Business, Seton Hall University, Class of 2019.

Posted by Kimberly Culcay.

In the article, “What the PCAOB’s new related-party standard means for auditors,” Maria L. Murphy captures the new standard put in place by the Public Company Accounting Oversight Board (PCAOB). The new standard will require auditors to perform specific procedures that are intended to strengthen auditor performance in high-risk areas, such as significant unusual transactions and financial relationships, and transactions with executive officers. The reason behind the new standard is that in the areas of accounting mentioned above there was a lack of guidance on how to report or treat certain transactions.

The Auditing Standard (AS) No. 18 requires auditors to understand the relationships and transactions with related party transactions as if they were someone working in the company. The auditors must also understand and document the process of understanding the relationships and transactions of the company just as the internal controls of the company itself. The auditors not only have to record how they gained understanding of the relationships and transactions but the auditors must properly account for the transactions, perform procedures to test that the company’s related parties and transactions with those parties have been completely and accurately identified, accounted for, and disclosed. Before this standard, there was a vague and unstructured way of handling related party transactions. Related party transactions are a way that a company can commit fraud by transferring property to a related party thereby creating a conflict of interest. In the article, it also states that the AU Section 316, Consideration of Fraud in a Financial Statement Audit, was amended to require specific procedures to identify and evaluate significant unusual transactions. The main point of amending the standards is for the professional auditors to be able to identify procedures quickly if a situation of fraud exists.

I think amending the standards of accounting to include specific procedures to prevent fraud from happening rather than a professional figuring out what to do if fraud is already done is way more useful. I also think that with the incentive to have these procedures in place, it eliminates some of the gray area of accounting. The need for Forensic Accountants has increased ever since the recession in 2008, with all of the fraud that was done due to the lack of strict standards and procedures to be able to detect fraud early. I am currently a graduate student at Montclair State University; I have been striving to complete my combined program in Accounting BS/MS with a Certificate in Forensic Accounting. Personally, I find that in the emerging economy people have learned from the mistakes made in the past with the scandals, fraud and so on. I think it is important to be a Forensic Accountant in order to apply sophisticated set skills in other aspects of accounting and litigation. I think that if you already know how to be an accountant and with some background knowledge on Forensics, then it could be easier to detect some of the common problems that lead to fraud.

Kimberly is an accounting major with a certification in forensic accounting at Feliciano School of Business, Montclair State University.

Reference:  Murphy, Maria L. “What the PCAOB’s New Related-party Standard Means for Auditors.” Journal of Accountancy. 22 July 2014. Web. 20 Oct. 2015. .

Posted by Sabrina Gilliam Formey.

Health care fraud may be more extensive than fraud in other industries because deception branches from an assorted group of players; those players being insurance companies, pharmacists, providers, suppliers, health care vendors, health care provider employees, physicians, specialists, and patients.  To compound the problem, some of those players are not only acting independently, but also participating in fraudulent activities within a network, or organized crime rings, and or with computer hackers who are unjustly profiting from committing health care fraud.  As a brief example, insurance billing claims that a facility submitted for a number of Alzheimer’s patients receiving “group therapy”, when they were actually placed in a room to watch the movie “Forrest Gump”, doesn’t scratch the surface on how persistent health care fraud has been; and how it continues to morph into new dimensions, that are discovered months and sometimes years after millions of dollars have been dispersed for fraudulent claims.

Lack of public awareness about health care fraud fosters a criminal subculture of operators that swindle unjust profits for their own personal gain.  Those fraudulent activities, not only create health and safety risks, but also drive up costs for healthcare.  These costs are later transferred to patients resulting in higher costs for care: higher employer sponsored or group premiums, higher deductibles, and higher co-pays.  Additionally, there are “double jeopardy” costs that further become a burden for citizens to bear through state and federal tax increases levied to close deficit gaps for government healthcare programs.

Common Channels for Health Care Fraud

1. Billing for services not rendered.

2. Billing for a non-covered service as a covered service.

3. Misrepresenting dates of service (billing one treatment date as separate dates).

4. Incorrect reporting of diagnoses or procedures (includes unbundling).

5. Overutilization of services.

6. False or unnecessary issuance of prescription drugs.

“According to the Centers for Medicare & Medicaid Services (CMS), national health expenditures in the U.S. reached $2.6 trillion in 2010 – 17.9 percent of GDP.”  With the expansion of coverage of an estimated 22 million people that were previously uninsured prior to the U.S. Affordable Care Act(ACA), health fraud crime will become an undeclared war between government agencies and insurance companies that are trying to stop these crimes and the many players that are many steps ahead due to the gap in systems, lack of controls, and stratagem for auditors/investigators deployed to  monitoring claims activities and continuous oversight that would be required.

Sabrina Gilliam Formey is a graduate student at the Feliciano School of Business, Montclair State University.

Article

10 popular health care provider fraud schemes ‘Do no harm’ isn’t their motto By Charles Piper, CFE, CRT

January/February 2013

http://www.acfe.com/article.aspx?id=4294976280

Additional Readings

• Health care: A ‘goldmine’ for fraudsters

January 13, 2010: 3:07 PM ET   By Parija Kavilanz, senior writer

http://money.cnn.com/2010/01/13/news/economy/health_care_fraud/

• Blockchain: Putting the ‘Block’ On Healthcare Fraud, Waste, And Abuse

July 19, 2017, 08:16:38 AM EDT By Michael Scott Bitcoin Magazine

http://www.nasdaq.com/article/blockchain-putting-the-block-on-healthcare-fraud-waste-and-abuse-cm817907

Additional Readings

• Health care: A ‘goldmine’ for fraudsters

January 13, 2010: 3:07 PM ET   By Parija Kavilanz, senior writer

http://money.cnn.com/2010/01/13/news/economy/health_care_fraud/

• Blockchain: Putting the ‘Block’ On Healthcare Fraud, Waste, And Abuse

July 19, 2017, 08:16:38 AM EDT By Michael Scott Bitcoin Magazine

http://www.nasdaq.com/article/blockchain-putting-the-block-on-healthcare-fraud-waste-and-abuse-cm817907

Posted by Abigail Hofmann.

Francisco Garcia of the Sacramento Kings was lifting weights on a Ledraplastic exercise ball on October 9^th, 2009. The 195 pound player was lifting two 80 pound weights while on the ball when it suddenly burst beneath him. This supposed “burst resistant” ball advertised its ability to withstand weight up to 600 pounds. In the fall, Garcia suffered a fracture to his forearm, causing ineligibility for upcoming games. This injury came shortly after signing a five year, $30 million contract. Because of this, the Sacramento Kings wanted “to recoup the more than $4 million in salary, medical expenses and other costs it incurred after Garcia’s injury, as well as prejudgment interest.” (Bricketto)

Ledraplastic initially refused to reimburse the Kings or Garcia for the financial loss or issue a statement recalling the products or forewarning about potential dangers. In the Kings’ product liability case, they were able to prove that the ball burst at weights of mere 400 pounds, rather than the advertised 600 pounds, and that “for a very small expense, the ball could have been made thicker and would have provided the burst resistant capacity as represented.” (Bricketto) Eventually, a settlement was done in private, but the Kings “sought reimbursement for the salary they paid Garcia,” and “Garcia had also sought damages for pain and suffering as well as loss in future earning capacity.” (Lu)

Ultimately, this product liability case was pretty clear on who was at fault: Ledraplastic claimed to have a ball that withstood weights up to 600 pounds, yet failed to hold even 400 pounds. This caused an injury resulting in millions of dollars of damages, and up until the settlement, Ledraplastic refused to forewarn others about this potential danger. Although the settlement was private, we do know that Ledraplastic is now required to warn users of the dangers of using the ball while lifting free weights, hopefully preventing many similar injuries.

Abigail is a management, marketing, and finance major at the Stillman School of Business, Seton Hall University, Class of 2019.

Works Cited:

Bricketto, Martin. “NBA Team Sues Exercise Ball Cos. Over $4M Injury – Law360.” NBA Team Sues Exercise Ball Cos. Over $4M Injury – Law360. N.p., n.d. Web. 08 Sept. 2016.

Lu, Andrew November 1, 2012 5:54 AM. “NBA Star Francisco Garcia Settles Exercise Ball Lawsuit.” Injured. N.p., n.d. Web. 07 Sept. 2016.

Bank of America must pay a Florida couple for failing to answer a harassment complaint.  The couple received relentless phone calls from the bank regarding past due payments on a mortgage.

BofA alleged the calls “were not to collect debt, but help the couple avoid foreclosure.”  The couple, however, claimed they received about 700 calls over a four year period.  At times, both their cell phones and home phone would ring in succession.  The couple filed suit in federal court under the Telephone Consumer Protection Act for harassment and subsequently received a default judgment. The judge refused to reconsider the order.

Default judgment is taught in business law class. This case exemplifies the importance of obeying court rules and responding promptly to a complaint.