3则医疗行业的舞弊小故事

医疗机构极易受到员工舞弊行为的影响。医生、牙医和他们的同行通常更愿意专注于照顾他们的病人，而不是从事枯燥、与经营相关的任务，这是业务运转必需的。

Physicians in smaller practices, especially, are likely to trust just one or two individuals to handle every financial aspect of the business — including receipts, invoices and bookkeeping. Medical practices are ripe for exploitation.

尤其是在小机构从业的医生，他们可能只信任一两个人来处理财务方向的业务——包括收据、发票和记账。医疗实践很容易被利用。

Through my work investigating medical employee fraud and speaking to victims, I’ve noticed emerging patterns. These case studies, which I’ve collected through my work experiences, exhibit some common red flags of fraud-susceptible medical practices. I’ve changed names and places.

通过调查医务人员舞弊和与受害者交谈，我注意到了新出现的模式。这些案例研究是我通过工作经验收集的，展示了易受舞弊影响的医疗行为的一些常见危险信号。我改了事件中的名字和地点。

In 2004, Benjamin Perlman, a Boston-based dentist, interviewed a young woman, Tina, to fill the business manager position at his practice. Tina was smart, confident and knowledgeable. He hired her on the spot.

2004年，波士顿牙医本杰明·帕尔曼（Benjamin Perlman）面试了一位年轻女性蒂娜（Tina），以填补他诊所的业务经理职位。蒂娜聪明、自信、知识渊博。他当场雇用了她。

Perlman had a lot going on in addition to his dental practice. He ran a charity dental clinic in the Middle East and held several real estate interests. He didn’t have the time or proclivity to manage the tiresome details of running his busy practice. Perlman felt that Tina could free him of that responsibility.

帕尔曼除了做牙医外，还有很多事情要做。他在中东开了一家慈善牙科诊所，并持有几项房地产权益。他既没有时间，也没有意愿处理他繁忙的经营中令人厌烦的细节。帕尔曼觉得蒂娜可以使他脱身于这种责任。

She proved uber-competent, so Perlman trusted her implicitly. He totally removed himself from financial operations and allowed her to run the practice as she saw fit. Tina opened all mail and cut every check, including her own paycheck. She made all the bank deposits and became well-acquainted with the bank employees. They knew that her boss trusted her and authorized her every request.

她证明了自己极强的能力，所以帕尔曼默认信任她。他完全不参与财务业务，允许她按照自己认为合适的方式经营这家公司。蒂娜查看所有的邮件，签发每一张支票，包括她自己的薪水。她经手所有的银行存款，并与银行的员工很熟。他们知道她的老板信任她，并批准她的每一项请求。

After about a year, Perlman began to notice that the business checking account seemed to be perpetually short on funds. He chalked it up to a temporary dip in business and didn’t give it much thought. He knew Tina had everything under control. One morning soon after, however, the bank notified Perlman that four checks had bounced. Confused, he paid a visit to the bank. The teller produced copies of the day’s checks for review. Perlman scanned the images and felt a pit form in his stomach. The very first check amounted to $1,500 — and was made out to Tina.

大约一年后，帕尔曼开始注意到商业支票账户似乎一直资金短缺。他把这归因于生意的暂时下滑，没有考虑太多。他知道蒂娜控制了一切。然而，不久后的一天早上，银行通知帕尔曼，有四张支票被拒付。他很困惑，于是去了银行。出纳员出示了当天支票的复印件以供审核。帕尔曼查阅了这些文件，感觉非常不好。第一张支票的金额是1500美元，是写给蒂娜的。

Perlman quickly asked to see all the practice’s activity for the last 30 days. He did some quick calculations and realized that, during this period, Tina had paid herself $10,000 on top of her normal paycheck. He immediately placed two phone calls. The first was to his accountant; the second was to the police. When Tina arrived to work that morning, two officers awaited her. She wordlessly supplied the officers with her lawyer’s business card and presented her wrists to be handcuffed.

帕尔曼很快要求查看过去30天的所有活动。他做了一些快速的计算，意识到在这段时间里，蒂娜除了正常的薪水外还支付给了自己1万美金。他立即打了两个电话。第一个是给他的会计师；第二个是报警。那天早上蒂娜上班时，两名警察在等她。她一言不发地向官员们提供了律师的名片，并伸出手腕以供戴上手铐。

Perlman ultimately discovered that Tina had embezzled more than $100,000 from his practice during her year of employment. And he wasn’t Tina’s first victim — she’d executed the same scheme at several other practices. Tina’s total ill-gotten gains had exceeded $500,000.

帕尔曼最终发现，蒂娜在工作的一年里从他的公司挪用了10万多美元。他并不是蒂娜的第一个受害者——她在其他几家公司也实施了同样的手法。蒂娜的非法所得总额超过了50万美元。

She was sentenced to two years in federal prison and deported to her native Vietnam after her release. Perlman wasn’t able to recover all the stolen money, and he had to borrow money from his sister to make it through the year.

她被判处两年联邦监禁，获释后被驱逐回祖国越南。帕尔曼没能追回所有被偷的钱，他只能向姐姐借钱以度过这一年。

Perlman now regularly reviews all the practice’s financial records. He also personally cuts every check and has all business mail delivered to his house. He’s determined to never be victimized this way again.

帕尔曼现在定期审查自己机构的所有财务记录。他还亲自签发每一张支票，并将所有商业邮件送到他家。他决心不再以这种方式受害。

The billing department at the Franklin Group, which ran a chain of pain-treatment centers, received a call from a patient, Gilbert Moriarty. Moriarty had found a credit card charge of $3,500 from the Franklin Group, but his copay should’ve been only $35. Clearly, a Franklin employee inadvertently added two zeros to the charge.

富兰克林集团经营着连锁疼痛治疗中心，该集团的结算部门接到了一位名叫吉尔伯特·莫里亚蒂的病人的电话。莫里亚蒂发现了富兰克林集团收取3500美元费用，但他的支付额应该只有35美元。显然，富兰克林的一名员工无意中在费用中加了两个零。

The billing department reviewed their records and found another problem. The Franklin Group had already issued a refund for the balance. Oddly, the check for $3,465 wasn’t mailed to Moriarty, but to an Anita Gonzalez at a totally unrelated address.

结算部门查看了他们的记录，发现了另一个问题。富兰克林集团已经对余额进行了退款。奇怪的是，这张3465美元的支票并没有寄给莫里亚蒂，而是寄给了一个完全不相关的地址和不相关的人安妮塔·冈萨雷斯。

Franklin’s billing department placed a call to Gonzalez and asked her if she’d received a check from the Franklin Group for $3,465. “I did,” she replied. “My mother works at Franklin. I’ll check with her and see if she knows anything about this.

”富兰克林的结算部门打电话给冈萨雷斯，问她是否收到富兰克林集团的3465美元支票。“是的，”她回答。“我母亲在富兰克林工作。我会和她核实一下，看看她是否知道这件事。”

The billing department found that Gonzalez’s mother, Amy Lopez, worked as a payment poster. Lopez was responsible for recording patients’ payments and alerting the accounting department when a patient overpaid so it could issue a refund. Lopez was immediately escorted off the premises.

结算部门发现，冈萨雷斯的母亲艾米·洛佩兹（Amy Lopez）是一名支付会计。洛佩兹负责记录患者的付款情况，并在患者多付时通知会计部门，以便其发放退款。洛佩兹立即被送离现场。

A subsequent investigation found that Lopez had manipulated the refund system so she could embezzle $50,000 within three years. Lopez would identify her victims by studying a master schedule of stale payments, which management rarely, if ever, reviewed. Lopez would change patient names and addresses to that of her family members in the computer system. Once accounting would issue a refund, Lopez would change the information back to the patient’s.

随后的调查发现，洛佩兹操纵了退款系统，以便在三年内盗用5万美元。洛佩兹将通过研究过时付款的总时间表来确定受害者，管理层很少对其进行审查。洛佩兹会在电脑系统中将患者的姓名和地址改为其家人的姓名和地址。一旦会计部门发出退款，洛佩兹就会将信息更改回患者的账户。

We spoke to every payment poster at Franklin. They all told us they didn’t need the ability to alter demographic information to perform their jobs. Therefore, Franklin payment posters are no longer able to change demographic information, and management now reviews the payment schedule each month.

我们对富兰克林的每一位支付会计都进行了谈话。他们都告诉我们，他们不需要改变人员信息来完成工作。因此，富兰克林的支付会计不再能够改变人员信息，管理层现在每月都会审查付款计划。

Steven Walsh’s father died when Steven was still a boy, and his uncle, Henry Walsh, assumed the role of father figure to his young nephew. When Steven went off to college, Henry encouraged his nephew to follow in his footsteps and become a doctor. Steven did so, even attending the same medical school as his uncle. He ultimately joined Henry’s orthopedics practice.

史蒂文·沃尔什的父亲在史蒂文还是个孩子的时候去世了，他的叔叔亨利·沃尔什担任了他年轻侄子的父亲角色。史蒂文上大学时，亨利鼓励他的侄子追随他的脚步，成为一名医生。史蒂文这样做了，甚至和他叔叔上的是同一所医学院。他最终加入了亨利的骨科诊所。

Five years into the venture, Steven’s wife, Linda, grew suspicious. She consistently earned more money in her job as a physical therapist than did her orthopedist husband even though his practice was busy. Henry’s wife, Debbie, kept the company’s books and handled all the practice’s mail. Henry assured Steven that his low salary was the result of a struggling practice. Steven trusted his aunt and uncle — the last thing he wanted to consider was that they were swindling him.

五年后，史蒂文的妻子琳达开始怀疑。她一直从事物理治疗师的工作比她的骨科医生丈夫收入更高，尽管丈夫的诊所很忙。亨利的妻子黛比保管着公司的账簿，负责处理公司的所有邮件。亨利向史蒂文保证，他的低工资是一次艰苦训练的结果。史提芬信任他的婶婶和叔叔——他从没想过他们在欺骗他。

Debbie eventually convinced Steven to approach his uncle and ask for access to the company’s books and tax returns, but Henry repeatedly rebuffed Steven. One afternoon, while Steven was chatting with the billing manager, he casually mentioned that the practice was doing poorly. The billing manager gave Steven a quizzical look. “What are you talking about?” she asked. “We’re clearing millions every year.”

黛比最终说服史蒂文去找他的叔叔，要求查阅公司的账簿和纳税申报表，但亨利一再拒绝史蒂文。一天下午，当史蒂文与结算经理聊天时，他漫不经心地提到这家公司做得很差。结算经理疑惑地看了史蒂文一眼。“你在说什么？”她问道。“我们每年清算数百万美元。”

Steven promptly hired an attorney and a team of CFEs. The team ultimately uncovered almost $2 million in damages and discovered that Henry and Debbie Walsh had paid all their personal expenses through the practice and drew unusually high salaries. In concert with their CPA, they’d hid their fraudulent activity from Steven for five years.

史蒂文立即聘请了一名律师和一组注册舞弊审查师。该团队最终发现了近200万美元的损失，并发现亨利和黛比·沃尔什从诊所支付了他们所有的个人费用，并获得了异常高的工资。他们的注册会计师和他们一起对史蒂文隐瞒了五年舞弊行为。

Steven eventually settled with his aunt and uncle out of court and took over as full owner with total access to the financial records. He now runs a thriving practice, but he hasn’t recovered from the emotional toll of his uncle’s betrayal.

史蒂文最终在庭外与他的婶婶和叔叔达成和解，并接管了公司，成为公司的完全所有者，完全可以查阅财务记录。他现在经营着一家生意兴隆的公司，但他还没有从叔叔的背叛所造成的情感创伤中恢复过来。

Unfortunately, none of these cases are unique. Medical partner fraud is more common than most medical professionals realize. Medical practitioners who wish to avoid employee fraud can take these steps to protect their practices.

不幸的是，这些案例都不是独一无二的。医疗合伙人舞弊比大多数医疗专业人员意识到的更为常见。希望避免员工舞弊的医生可以采取这些措施来保护他们的诊所。

l Consider having business mail sent to your home, a step Perlman adopted. This will minimize, if not eliminate entirely, the opportunity for employees to tamper with correspondence.

考虑将商业邮件发送到你的家，这是帕尔曼采取的步骤。这将最大限度地减少（如果不是完全消除的话）员工篡改通信的机会。

l If you run a small practice, don’t entrust an employee to cut checks. Write the checks yourself. It’s too easy for an employee to take an unauthorized cut of your earnings. Remove that temptation and avoid defalcation.

如果你经营一家小公司，不要委托员工开支票。而是自己开支票。员工很容易就擅自从你的收入中开支票。消除这种诱惑，避免挪用公款。

Properly segregate duties. Henry and Debbie Walsh were able to cheat their nephew for five years because they handled the books and taxes. Had Steven been responsible for some of the practice’s fiscal tasks, his uncle would’ve struggled to hide his illicit financial activity.

适当划分职责。亨利和黛比·沃尔什能够欺骗他们的侄子五年，因为他们处理账目和税收。如果史蒂文负责该机构的一些财务任务，他的叔叔将很难隐藏他的非法财务活动。

Familiarize yourself with the bookkeeping and business side of your practice. Franklin employees know that, after the Lopez incident, the chances of getting anything by management are slim to none. The knowledge that you regularly review the books should be enough to deter most ethically challenged employees from defrauding the practice.

熟悉记账和经营方面的业务。富兰克林的员工知道，洛佩兹事件发生后，管理层得到任何东西的机会微乎其微。你定期查看这些账簿的知识应该足以阻止大多数道德受到挑战的员工进行舞弊。

Take control of your books and protect your practice. Maybe it’s boring and tedious. But better bored than defrauded.

控制你的账簿，保护你的行诊所。也许这既无聊又乏味。但无聊总比受骗好。

Joshua Wiesenfeld, CFE, CPA, is a financial investigator at Labaton Sucharow, LLP. 

乔舒亚·维森菲尔德，注册舞弊审查师，注册会计师，是拉巴顿·苏查罗律师事务所的财务调查员。

联系他：Joshua.wiesenfeld@gmail.com

原文链接:

https://www.fraud-magazine.com/article.aspx?id=4295011496