Fraud investigation definition

Fraud investigation means an independent review or examination by Retirement Systems Division staff or authorized representatives who are assisting the Retirement Systems Division staff of records, activities, actions, or decisions by employers or other affiliated or associated entities having an impact on the Retirement System. The purpose of a fraud investigation is to help detect and prevent fraud and to ensure full accountability in the use of pension funds.
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Fraud investigation means the formal evaluation of the information on a person’s application for a driver’s license or identification card; identifying documents; a digital image, signature, or driving record; or any other information received by a trained examiner to determine authenticity; lawful status; or violations of federal regulations, state law, or state rules and regulations. It shall also include the formal inquiry into questionable activities of Department employees in the performance of their job duties for violations of Department rules and regulations or state or federal law.
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Fraud investigation means a formal evaluation or inquiry of the
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Examples of Fraud investigation in a sentence

  • Identifying associations between providers, practitioners, and beneficiaries that indicate rings of collusive fraudulent activity; and (II) Discovering recipient attributes that indicate improper eligibility, including but not limited to death, out-of-state residency, inappropriate asset ownership, or incarceration; and (c) Fraud investigation services that combine retrospective claims analysis and prospective waste, fraud, or abuse detection techniques.

  • Records and investigates all incidences including suspected and confirmed fraud, in line with MC Guidance on Conducting a Fraud investigation.

  • Fyber may use third party service providers for Fraud detection and may disclose the identity of Supply Partner to such third parties as part of any Fraud investigation in connection with Supply Partner’s Account.

  • Fraud investigation work papers, compliance investigation work papers, and other evidence or related supportive material directly pertaining to the work of the Retirement Systems Division of the Department of State Treasurer shall be retained according to an agreement between the Director of Retirement and State Archives.

  • Repay any Overpayments that: Pertain to services provided at any time during the term of this Contract; and Are identified through an HCA audit or other HCA administrative review at any time on or before ten (10) years from the date of the termination of this Contract; or Are identified through a Fraud investigation conducted by the Medicaid Fraud Control Division (MFCD) or other law enforcement entity, based on the timeframes provided by federal or State law.

  • The change of the previous regulation is that the intention of the perpetrator in view of the abuses of the official position or rights is sufficient.Anti-fraud cycle: Fraud investigation and prosecution, single measure, legislative measure, change - update of legislation, improvement of legislation, criminal sanctions.

  • The model provides the capability to increase the efficiency and effectiveness of Fraud investigation by simplifying and streamlining the process for recording, allocating and investigating Fraud.

  • Fraud investigation should be handled by specialist staff remote from day-to-day operations, who may also guide the 1st line of defence in such activities where trained resource is available.

  • AML, Record retention, Outsourcing, Fraud investigation, Information Security and Business continuity.The Bank invests in risk insurance based on the requirement viz.

  • Fraud investigation is a type of tax audit that investigates criminal which arises from where the most serious cases of noncompliance.


More Definitions of Fraud investigation

Fraud investigation means an independent review or examination by Retirement Systems Division staff or authorized representatives who are assisting the Retirement Systems Division staff of records, activities, actions, or decisions by employers or other affiliated or associated entities having an impact on the Retirement System. The purpose of a fraud investigation is to
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Related to Fraud investigation

  • Investigation means the Bureau’s decision to hold and not process the Company’s license renewal applications identified in Appendix A due to the Company’s inability to certify compliance with its public file obligations.

  • Background investigation means the investigation conducted by a licensee or applicant to support the determination of trustworthiness and reliability.

  • Remedial investigation means a process to determine the nature and extent of a discharge of a contaminant at a site or a discharge of a contaminant that has migrated or is migrating from the site and the problems presented by a discharge, and may include data collected, site characterization, sampling, monitoring, and the gathering of any other sufficient and relevant information necessary to determine the necessity for remedial action and to support the evaluation of remedial actions if necessary;

  • Investigations The Xxxxxxx, when requested by one or a number of employees whom he/she represents, may investigate the basis for any dispute arising under this Agreement and may, at any stage, assist the employee(s) in seeking resolution of such dispute through the grievance procedure provided herein. A representative of the Union may substitute in place of the Xxxxxxx.

  • EXPERIMENTAL OR INVESTIGATIONAL means any healthcare service that has progressed to limited human application, but has not been recognized as proven and effective in clinical medicine. See Experimental or Investigational Services in Section 3 for a more detailed description of the type of healthcare services we consider experimental or investigational.

  • Site investigation means the collection and evaluation of data adequate to determine whether or not discharged contaminants exist at a site or have migrated or are migrating from the site at levels in excess of the applicable remediation standards. A site investigation shall be developed based upon the information collected pursuant to the preliminary assessment;

  • Investigating Department means any department / division / office of SCI investigating into the conduct of the Entity and shall include the Vigilance Department, “Central Bureau of Investigation, the State Police or any other authority or entity set up by the Central or State Government having powers to investigate”.

  • Investigative information means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation.

  • Investigational Product means the Study Drug identified above and the control material, as further detailed in the Protocol;

  • Investigating Officer means the person appointed by the Monitoring Officer to undertake a formal investigation of a complaint alleging a breach of the Code of Conduct by a Subject Member. The Investigating Officer may be another senior officer of the Borough Council, an officer of another authority or an external investigator.

  • Threatened litigation as used herein shall include governmental investigations and civil investigative demands. “Litigation” as used herein shall include administrative enforcement actions brought by governmental agencies. The Grantee must also disclose any material litigation threatened or pending involving Subcontractors, consultants, and/or lobbyists. For purposes of this section, “material” refers, but is not limited, to any action or pending action that a reasonable person knowledgeable in the applicable industry would consider relevant to the Work under the Grant Agreement or any development such a person would want to be aware of in order to stay fully apprised of the total mix of information relevant to the Work, together with any litigation threatened or pending that may result in a substantial change in the Xxxxxxx’s financial condition.

  • Investigative consumer report means a consumer report or portion thereof in which information about a natural person's character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with the person's neighbors, friends, associates, acquaintances, or others who may have knowledge concerning such items of information.

  • Contractor Related Parties means any affliates of the Contractor and the Contractor's executive officers, Pennsylvania officers and directors, or owners of 5 percent or more interest in the Contractor.

  • Inquiry means information gathering and initial fact finding to determine whether an allegation or apparent instance of misconduct warrants an investigation.

  • Investigation Committee means the Investigation Committee appointed by the Board under Regulation 5 of these Regulations;

  • Criminal investigatory record means a record which is not

  • Threatened species means endangered species, including flora and fauna, listed in the European Red List or the IUCN Red List, as referred to in Section 7 of Annex II to Delegated Regulation (EU) 2021/2139;

  • Allegation means any written or oral statement or other indication of possible scholarly misconduct made to an institutional official.

  • Current significant investigative information means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the audiologist or speech-language pathologist to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.