Please read the case study #2 and answer as if you were the administration of th

Question

Please read the case study #2 and answer as if you were the administration of the organization how could you use internal audit to uncover the fraud before an external audit occurred? what types of internal audit would you use? be certain to include a clear description of the scope of your audit.

0133372977/cf n Freed-Harde Home Page-Engage Only1 P Case Study #2 Lee R. Rocamora, M.D., North Carolina, agreed to pay $106,600 to resolve his liability for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the practitioner requested pay ments from Medicare beneficiaries in violation of his assignment agreement. Specifically, the practitioner allegedly asked his patients to enter into a membership agreement for his patient care program, under which the patients paid an annual fee. In exchange for the fee, the membership agreement specified that the practitioner would provide members with (1) an annual comprehensive physical examination, (2) same day or next day appointments, (3) support nel dedicated exclusively to members, (4) 24 hours a day and 7 days a week physician availability, (5) prescription facilitation (6) coordination of referrals and expedited referrals, if medicaily necessary, and (7) other service amenties as determined by the practitioner Souce US. Department of Healih & Haman Services Case Study #3 nsealed today charging Penn Choice

Explanation / Answer

As the administration I would be conducting an internal audit based on a particular time period in order to ensure that all the feactors and aspects are in place and there is no violation or any fraud. External audits are something that may actually affect the reputation of the organization if the internal audit is unable to make any findings of fraud that is being done by external audit. I believe that in order to make the process of internal audit effective I would have been using the types like:

1. Compliance Audit - This will ensure that any activity that is being taken place is is ahering to established laws, standards and regulations.

2. Financial Audit - This audit is conducted in order to ensure that the budget prepared and the current expenses are as per the plan and there is no deviation from the same.

3. Investigations - This is a kind of inquiry which helps in understanding the suspected frauds or misuse of assets or non adherence to rules and regulations and this is one of the most important type of audit which should be strict so that it is resolved and determined by the process of internal audit itself.

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