Fraud Cases Research Articles

Identifying and Removing Fraudulent Attempts to Enroll in a Human Health Improvement Intervention Trial in Rural Communities

Using the internet to recruit participants into research trials is effective but can attract high numbers of fraudulent attempts, particularly via social media. We drew upon the previous literature to rigorously identify and remove fraudulent attempts when recruiting rural residents into a community-based health improvement intervention trial. Our objectives herein were to describe our dynamic process for identifying fraudulent attempts, quantify the fraudulent attempts identified by each action, and make recommendations for minimizing fraudulent responses. The analysis was descriptive. Validation methods occurred in four phases: (1) recruitment and screening for eligibility and validation; (2) investigative periods requiring greater scrutiny; (3) baseline data cleaning; and (4) validation during the first annual follow-up survey. A total of 19,665 attempts to enroll were recorded, 74.4% of which were considered fraudulent. Automated checks for IP addresses outside study areas (22.1%) and reCAPTCHA screening (10.1%) efficiently identified many fraudulent attempts. Active investigative procedures identified the most fraudulent cases (33.7%) but required time-consuming interaction between researchers and individuals attempting to enroll. Some automated validation was overly zealous: 32.1% of all consented individuals who provided an invalid birthdate at follow-up were actively contacted by researchers and could verify or correct their birthdate. We anticipate fraudulent responses will grow increasingly nuanced and adaptive given recent advances in generative artificial intelligence. Researchers will need to balance automated and active validation techniques adapted to the topic of interest, population being recruited, and acceptable participant burden.

Securing transactions: a hybrid dependable ensemble machine learning model using IHT-LR and grid search

Financial institutions and businesses face an ongoing challenge from fraudulent transactions, prompting the need for effective detection methods. Detecting credit card fraud is crucial for identifying and preventing unauthorized transactions. While credit card fraud incidents are relatively rare, they can result in substantial financial losses, particularly due to the high monetary value associated with fraudulent transactions. Timely detection of fraud enables investigators to take swift actions to mitigate further losses. However, the investigation process is often time-consuming, limiting the number of alerts that can be thoroughly examined each day. Therefore, the primary objective of a fraud detection model is to provide accurate alerts while minimizing false alarms and missed fraud cases. In this paper, we introduce a state-of-the-art hybrid ensemble (ENS) dependable machine learning (ML) model that intelligently combines multiple algorithms with proper weighted optimization using grid search, including decision tree (DT), random forest (RF), K-nearest neighbor (KNN), and multilayer perceptron (MLP), to enhance fraud identification. To address the data imbalance issue, we employ the instant hardness threshold (IHT) technique in conjunction with logistic regression (LR), surpassing conventional approaches. Our experiments are conducted on a publicly available credit card dataset comprising 284,807 transactions. The proposed model achieves impressive accuracy rates of 99.66%, 99.73%, 98.56%, and 99.79%, and a perfect 100% for the DT, RF, KNN, MLP and ENS models, respectively. The hybrid ensemble model outperforms existing works, establishing a new benchmark for detecting fraudulent transactions in high-frequency scenarios. The results highlight the effectiveness and reliability of our approach, demonstrating superior performance metrics and showcasing its exceptional potential for real-world fraud detection applications.

How effective is legal protection in Indonesia in handling investment fraud cases compared to other countries?

Legal protection for investors is crucial in preventing the negative impact of rampant investment fraud, especially in the digital era that facilitates access to information. The ever-growing phenomenon of investment fraud shows the importance of evaluating the effectiveness of existing legal frameworks. This study aims to analyze the effectiveness of legal protection in Indonesia in dealing with investment fraud cases, with a normative juridical approach that examines relevant regulations in Indonesia and compares them with other countries such as the United States and India. This method is used to understand the weaknesses and challenges in the implementation of existing laws. The results of the study show that although Indonesia has a comprehensive legal framework, such as Law Number 8 of 1995 on the Capital Market and the Electronic Information and Transaction Law (UU ITE), challenges in law enforcement and public education are still significant obstacles. Unlike the US and India, which implement strict sanctions and have strict supervision, legal protection in Indonesia still needs reforms to increase the deterrent effect for actors and strengthen public trust in the investment system.

Investigating the Structural Model of Whistle Blowing System on Government Procurement Fraud: Examining Mediating Effect of Investigative Audit

This study aims to develop a fraud disclosure model in government procurement in Indonesia through a whistle blowing system with an investigative audit as a mediator. Disclosure of fraud is the result of an investigative audit. The effectiveness of the implementation of investigative audit procedures will be achieved if the auditor has the ability to carry out each stage in the audit standard. To maximize the performance of investigative audits, a system is needed to uncover fraud. The whistleblowing system is expected to be an effective tool to reveal fraud in government procurement. The research was conducted by distributing questionnaires to respondents electronically by sending a google form link containing a list of questions to auditors at the Supreme Audit Agency (BPK) and internal auditors at the Financial and Development Supervisory Agency (BPKP) throughout Indonesia. The results of the study found that the use of a whistle blowing system could increase the effectiveness of investigative audits on government procurement. Another finding is that investigative audits can reduce the disclosure of government procurement fraud. The effectiveness of the whistle blowing system in reducing the level of disclosure of government procurement fraud does not occur directly, but must be mediated by a good investigative audit. The results of this study indicate that the reporting of government procurement fraud cases on the whistle blowing system must be followed up with a thorough investigative audit so that disclosures of government procurement fraud cases can be traced better. Additional analysis in this study shows that although the functions of external auditors and internal auditors are different, the level and type of disclosure of government procurement fraud do not differ.

SOME ASPECTS OF RESEARCHING THE PROBLEM RISKS IN INSTITUTIONAL MANAGEMENT TRANSFORMATIONS IN THE FIELD OF EDUCATION: US EXPERIENCE

The article is devoted to the analysis of the American accounting experience potential risks in the management of institutional transformations. Goal articles - to reveal some aspects of the US experience in taking into account risks in management institutional transformations in education. Theoretica research methods applied: study of scientific literature, analysis, systematization, comparison, specification, generalization of information. The implementation of transformations in the educational sector (of institutional transformations) is associated with the emergence of certain risks. There is set of potential risk factors with which any organization, including higher educational institutions, collides permanently or temporarily, including: threats from natural disasters such as hurricanes, fires from thunderstorms lightning, floods, etc.; failures and failures in the operation of service systems of the type interruptions and power outages, protection failure, failures equipment, etc.; malicious actions such as sabotage, terrorism, computer actions fraud; the so-called human factor, that is, errors due to negligence employees, their lack or lack of necessary knowledge and skills. Taking into account the peculiarities of educational organizations, it is suggested to divide all potential risks and the necessary institutional transformations associated with them into four main categories: strategic risks, financial, legislative, etc operating rooms Strategic risks involve long-term threats that can to influence the successful activity of a higher educational institution. Financial risks foresee the possibility of loss of material means and other assets. Legislative risks involve improper implementation of state laws and instructions, as well as local regulations when implementing institutional ones transformations Operational risks involve erroneous actions of individuals, cases of fraud in the university environment. In addition, one more is known a category of risk that is very important for educational institutions is the risk of losing reputation The reputation of the higher educational institution, its image and prestige have of great importance for the successful functioning of higher education institutions. Higher education institutions should participate in the evaluation of their propensity to risks and have a complete understanding of all the categories of risks they may face to meet The article analyzes some possible approaches to risk assessment, which are offered by American scientists. Expediency is emphasized the use of American experience in Ukraine, where they are taking place today significant institutional transformations in the field of education.

Does Reporting of Aksi Cepat Tanggap Cases Affected Public Trust on Zakat Institutions?

Research Originality: Funds misallocation comitted by ACT identified as fraud and the non-transparent financial that reported in online mass online media in terms of negative reporting. This influence has never been studied on the loyalty of zakat payer (muzakki) of paying Zakat, Infaq, and Shadaqah (ZIS) in Islamic philanthropy institutions (LAZ) admidst related to negative reporting of ACT.Research Objectives: This research analyze the impact of transparency, fraud management and the cases reporting of ACT on public trust in paying zakat, infaq, shadaqah in other Islamic philanthropy institutions.Research Methods: This research setted in the Bogor City among 100 respondents of muzakki in the year 2023 and 2024. Then, multiple linear regression were involved to analyze the impact of independent variables on dependent variable.Empirical Results: The results reveal that being transparent and avoiding fraud cases will significantly increase public trust in paying ZIS at LAZ institutions. Meanwhile, coverage of the ACT cases had no impact on the loyalty of muzakki who were also well-educated.Implications: LAZ are encouraged to provide information related to ZIS funds management, so that trust of the muzakki will increase. Besides, LAZ also needs to have a strong internal control system to enforce transparency in financial reporting, and effective monitoring mechanisms to prevent fraud.JEL Classification: G23, G30, Z12

Storytelling for Social Justice: Reconceptualizing Invisibility, Legitimacy, and Self-Censorship via Stories of Failure

ABSTRACT Building upon scholarship on stories – including oral-history and oral-tradition – this article considers often-silenced narratives in the form of stories of failures. Comparison between empirical research and qualitative methodologies highlight value of fictional storytelling, which has been mobilized by researchers to protect the anonymity of vulnerable groups and the intersectionally marginalized in research. While hierarchies in power lead to self-censorship and self-delegitimization as observed by bell hooks and Paulo Freire, stories of failure may resist social pressures to present successes – which in themselves have led to widely disseminated cases of academic fraud. Additionally, stories of failures may help acknowledge Kemmis and Mezirow’s considerations of negative emotions as valid, toward resolution, resistance, and social change. Stories may help elucidate the hidden curriculum, which confounds efforts toward social justice under Rawlsian theories. Lastly, these stories may elucidate the impacts of interest convergence under critical race theory, towards the promotion of social justice intersectionally.

Shaping the Narrative: Examining News Coverage of Voter ID Laws in the United States

ABSTRACT This study is the first to examine US news coverage of voter ID laws. Voter ID requirements are central to ongoing political debates about voting procedures. Despite rare cases of voter fraud by impersonation and the strong polarization over voter ID among partisan elites, there is a surprising broad bipartisan support for voter ID among the American public. Using a range of inductive computational content analysis methods, we analyse news coverage of voter ID requirements from 2013 to 2023. We find coverage differs by outlets political leaning and demonstrate a link between news media discourse and elite framing on the issue. Donald Trump’s voter fraud allegations, however, appear to have substantially shaped left-leaning media coverage from 2016, raising concerns around whether this might have helped amplify electoral conspiracies, instead of offering the public alternative ways of thinking about voter ID laws.

MORPHIC COMPUTING WITH MACHINE LEARNING FOR ENHANCED FRAUD DETECTION IN FINANCIAL APPLICATIONS

As financial fraud becomes increasingly complex, traditional detection methods struggle to keep pace, resulting in substantial financial losses globally. Morphic computing—a paradigm that emphasizes adaptable, context-aware processing—offers promising advancements for fraud detection in dynamic environments. Integrating morphic computing with machine learning models creates a responsive framework capable of discerning subtle and evolving fraud patterns. The proposed system utilizes a Convolutional Neural Network (CNN) enhanced with Morphic Layering, where layers adaptively morph in response to new data patterns. The dataset, sourced from real-time financial transactions, consists of 500,000 records, including 2,000 flagged fraudulent cases. The system was tested on a simulated environment over a six-month period, yielding an accuracy of 98.5% in fraud detection and reducing false positives by 40% compared to traditional machine learning models. Latency for real-time detection was minimized to 200 milliseconds, proving feasible for immediate application in transaction monitoring systems. By offering a flexible structure, this method surpasses existing approaches, as it continuously evolves to detect emerging fraud patterns, thus enhancing financial security.

온라인 무역사기 사례에 관한 연구: 이메일 해킹 무역사기 사례를 중심으로

Purpose: This study focuses on the fact that fraud using email, which is a major means of communication in trade transactions, continues to occur. To raise awareness of the email hacking risks, this study suggests practical countermeasures through analysis of fraud that has caused damage and cases of attempted fraud. Research design, data, and methodology: Along with a literature review, this study focuses on successful and attempted email hacking trade fraud based on recent data from KOTRA. Results: According to the analysis, representative types of email-related trade fraud are mainly “new forms of email account hacking” and “existing forms of similar email alteration fraud cases”. Recently, in response to changes in companies' awareness of email fraud, the number of cases has decreased, but caution is required because fraudsters are becoming more detailed and sophisticated in their approach. Conclusions: This paper encourages step-by-step practical and policy alternatives in order to be suspicious of (and to confirm) account change requests based on the changing perception of fraud by email, which is the main means of communication for traders.

Strengthening Fraud Control Plan For Investigative Audit And Probity Audit In Fraud Detection

The high number of corruption cases in local governments in Indonesia demands increased government attention to fraud cases. Opportunity for fraud can start from the planning stage to follow-up so that appropriate preventive and repressive handling efforts are needed. The Financial and Development Supervisory Agency has developed a fraud control plan and probity audit guidelines that are expected to be a solution to eradicate fraud in local governments. This study aims to analyse the effect of implementing investigative and probity audits on strengthening the fraud control plan in detecting fraud by auditors of the Financial and Development Supervision Agency of South Sulawesi and West Sulawesi. This study used quantitative with multiple linear analysis with Smart PLS 3.0 Software. Results found that investigative and probity audits positively affect fraud detection. Meanwhile, the fraud control plan does not strengthen the relationship between investigative and probity audits to fraud detection.

Preventing Corruption in Bali’s Customary Villages: How Do Regional Institutions Play a Role?

Customary villages are traditional institutions in Bali that have existed for centuries. The village has autonomy when it comes to managing its customary arrangements based on local traditions and wisdom, meaning that it does not have a hierarchical relationship with the government based on the state structure of the Republic of Indonesia. The Bali Province Government, a second-layer hierarchical government structure in Indonesia, applies a unique approach to performing relationships with customary villages in Bali as it has regularly supported the existence and activities of customary villages, including providing funding assistance. Unfortunately, several cases have shown the misuse of government funds. This article, therefore, identifies the practice of fraud and corruption in customary villages in Bali. Second, it analyses the role of the Customary Community Development Agency (DPMA) of the Bali Province Government in supervising the financial management of Bali's customary villages. Lastly, it supports the synergy between DPMA and the Representative Office of the Financial and Development Supervisory Agency (BPKP) of Bali Province in preventing corruption cases in the customary villages. The article applies empirical legal research, which involves collecting primary and secondary data and analyzing them using statutory, factual, and legal concept analysis approaches. The research suggests that fraud and corruption cases in customary villages cause a loss of government funds, harming the financial management of Village Credit Institutions (LPD), and involving the misuse of power. The provincial regulation authorizes DPMA to address this issue by monitoring how customary villages use the Bali Province Government grants. This paper then argues that the DPMA’s role would be more effective if it adopted a more formal collaboration with the Representative BPKP in Bali Province through various joint programs that support the comprehensive efforts to prevent corruption in customary villages in Bali.

An assessment of convicted cryptocurrency fraudsters

ABSTRACT We examine cryptocurrency fraud cases prosecuted by Nigeria's Economic and Financial Crimes Commission (EFCC). We considered the lens of the Space Transition Theory (STT) in exploring the dynamics of these digital crimes. Our data analysis reveals common types of fraud, including cryptocurrency investment schemes. The results show an exclusive male demographic (100%), with the majority under 30 years old and only a quarter possessing a degree, providing insights into the socio-demographic characteristics of cryptocurrency fraudsters. Additionally, while most fraudsters (55%) targeted victims in the United States, Bitcoin, leveraging blockchain technology, was the most commonly used method (46%) for cryptocurrency fraud. Our examination of the methods and mediums used for cryptocurrency fraud supports some aspects of STT, while others do not. We advocate for a multifaceted strategy that prioritises stringent regulation, implementation, and heightened scrutiny of digital currency ecosystems in Nigeria and beyond. This study contributes to the broader discourse on cybercrime prevention and enforcement by emphasising the novel methodological approach utilised.

Factors influencing asset misappropriation in financial institutions: The application of fraud diamond theory

Fraud cases in financial institutions have increased globally in recent years and Malaysia is no exception. Internal actors committed the most frauds, causing 69% of organisations to suffer from their actions, as compared to only 17% organisations dealing with frauds caused by external actors. Moving towards the future, a greatest concern of fraud in Malaysia revolves around asset misappropriations. It is necessary to understand why people commit fraud to reduce the number of asset misappropriation occurrences. Thus, the research aims to investigate factors influencing asset misappropriation in financial institutions. The research suggested elements in the Fraud Diamond Theory as influencing factors, namely pressure, opportunity, rationalization, and capability. Data for the research was obtained from a survey questionnaire that polled public attitudes with regards to the selected factors influencing asset misappropriation occurrences. 111 respondents participated in the survey, for which the findings showed that only pressure and capability had a significant relationship with asset misappropriation. Opportunity and rationalisation were found to have no significant relationship with asset misappropriation. This implies that personal integrity is a more critical issue, as compared to rationalisation. The research is hoped to help financial institutions by assisting banking and financial sectors, as well as policymakers in managing risks of fraud and developing policies to reduce operational risk.

Assessing Mobile Network Fraud Threats and Prevention Strategies in Kenya

Background: Mobile network technology has exponentially advanced in the last decade and with this development, fraud activities have risen in equal measure resulting in companies and customers losing huge amounts of money as a result of, especially in developing economies that lag in the regulatory frameworks when it comes to Mobile network fraud. The purpose of the study was to explore Mobile network fraud in Kenya identifying the most common types of fraud, ways which service providers and regulators are employing to prevent or reduce fraud, methods currently used to detect fraud, and gaps thereof. Finally, the effect of concept drift in the automated fraud detection process. Method: A qualitative research method was adopted for the study and using a semi-structured question guide, four focus group discussions composed of 23 participants were conducted. The criteria used for selecting and placing participants into focus groups considered the following: The expert area of the participant, years of experience in the fraud ecosystem of the participant, and the organization to which the participant is attached. The availability and willingness of the participants were also considered in the selection process. The focus group approach was selected as it facilitated balanced discussion amongst all the players in the Kenyan fraud ecosystem, harnessing the power of group dynamics as it involved the regulators and the service providers who were drawn from different organizations. Results: The mobile network fraud ecosystem was stratified into three dimensions namely Fraud prevention which looked at the policies and methods used by both regulators and service providers to reduce fraud, Fraud categorization which aimed at categorizing different types of mobile frauds, and finally the Fraud detection which looked at the current tools being used to detect fraud. From the study, it emerged that although the regulators have provided strict guidelines on the customer onboarding process, not all service providers are currently using biometric approaches while onboarding new customers as this was highlighted as the entry point of most fraud cases. The study established five major types of Mobile network fraud in Kenya: SIM swap, SIM boxing, Wangiri, Commission arbitrage, and Hoax SMS and scams. Most of this fraud is committed using either SMS or voice channels; in some cases, both channels are used. Different matrixes derived from multiple factors are used by service providers while evaluating the criticality of fraud cases though not enforced by the regulators. The study also revealed that most of the fraud detection processes amongst the service providers still use manual tools that constantly require human input. While some of the detection processes are automated, concept drift is a major challenge for automated classification models due to the constant evolution of fraud patterns. Conclusion: The study revealed gaps in Mobile Network fraud prevention processes in Kenya as service providers still use non-biometric customer validation processes that are open to forgery and exploitation. A strict customer onboarding process that is fully automated and integrated should be used to address this gap. In the fraud categorization, there is no clear universal categorization matrix to guide the service providers while assessing the criticality of fraud and in this regard, a qualitative scientific model should be developed and used by all the stakeholders as a reference point. When it comes to fraud detection, concept drift is a major challenge, and service providers in Kenya still rely on manual processes due to the dynamic nature of mobile fraud. This exposes a huge gap in the detection process and there is a need to address this by developing systems and processes that will automatically detect and react to concept drift while automating the detection processes.

Analyzing the fraud tendency in the Indian Banking sector

At present, the Indian banking sector is having of worldwide importance for a few years due to its robust regulatory measures and least bank failures during recession and other difficult situations. Banking plays a prominent role in providing required monetary resources for every sector to meet their objectives. At the same time, the banking sector has been facing major challenges like increasing fraudulent cases as Indian banks lost Rs.5.22 lakh crores public money by a way of fraud reporting during the last twelve years, which dents our country’s economy badly. The current study is to analyze the fraud trend and nature wise frauds in Indian public and private sector banks during the period 2012-2023 and further, the current research aims to study the measures taken by Reserve Bank of India and individual banks to curtail the frauds during the said period. Primary data was obtained from bank employees and secondary data from authenticated sources was taken for this study. Our finding revealed that several bank frauds do not differ significantly between the public and private sector banks in terms of amount under cheating & forgery and fraudulent encashment nature. Further, it was observed that fraud amount reporting by public sector banks and private sector banks has been decreasing in trend since 2020 due to the preventive steps initiated by RBI and individual banks.

Valeant pharmaceuticals fraud

Purpose The aim of this study is to examine the patterns of fraud present in Valeant’s 2014 and 2015 financial statements and determine through a risk management analysis whether these frauds could have been prevented. This analysis provides the opportunity to more effectively prevent financial statement fraud. Design/methodology/approach Data were collected from Valeant pharmaceuticals annual reports, financial statements reports and financial authority documentation. Based on these documents, this paper analyzes the different fraud schemes and investigate whether fraud could have been detected earlier by governance actors. In particular, this paper examines the firm’s financial statements three years before the fraud was detected by the Securities and Exchange Commission. Findings The analysis of financial statements reveals few clues and no alarming red flags three years before detection of the fraud. However, financial statement analyses were complex because of the many acquisitions the firm made in the years before. Originality/value This paper aims to contribute to the literature on fraud by investigating a case of financial statement fraud.

Microfinance in Nepal: An Overview

This paper aims to explore the current challenges and opportunities of the microfinance sector in Nepal. The secondary data and descriptive research with a critical approach are adopted to explain the study. The data were mainly collected from Nepal Rastra Bank's (NRB) annual Reports, and other available literature. The result shows that the center numbers (numbers of microfinance user group) change ratio was reduced from 17.11% to 1.30%, the total group numbers were 13% to 2.88%, the borrower 7.51% to (-9.66%), staff progress 9.75% to (-3.48%), loan outstanding 41.18% to (-5.06), profit 150.53% to (-7238), active loan 40.26 to (-7.94), and saving 22.87 to 3.91 between 2020/2021 to 2022/2023. Similarly, the Overdue member change ratio increased upto 53.66%, the passive loan from 79.47% to 104.3%, and the NPL increased continuously from 2.56% to 5.52%. So, all microfinance institutions are in a critical situation in Nepal. However, microfinance is an important concept to reduce poverty and unemployment. Further, it enhances easy access to financial institutions in rural where large banking institutions are merely available. However, microfinance in Nepal is facing critical challenges as many fraud cases are emerging. The policy implication is crucial as policymakers should formulate both long-term and short-term policies and implement those policies immediately in microfinance to revive the critical current situation.

Developing Surveys on Questionable Research Practices: Four Challenging Design Problems

AbstractThe exposure of scientific scandals and the increase of dubious research practices have generated a stream of studies on Questionable Research Practices (QRPs), such as failure to acknowledge co-authors, selective presentation of findings, or removal of data not supporting desired outcomes. In contrast to high-profile fraud cases, QRPs can be investigated using quantitative, survey-based methods. However, several design issues remain to be solved. This paper starts with a review of four problems in the QRP research: the problem of precision and prevalence, the problem of social desirability bias, the problem of incomplete coverage, and the problem of controversiality, sensitivity and missing responses. Various ways to handle these problems are discussed based on a case study of the design of a large, cross-field QRP survey in the social and medical sciences in Sweden. The paper describes the key steps in the design process, including technical and cognitive testing and repeated test versions to arrive at reliable survey items on the prevalence of QRPs and hypothesized associated factors in the organizational and normative environments. Partial solutions to the four problems are assessed, unresolved issues are discussed, and tradeoffs that resist simple solutions are articulated. The paper ends with a call for systematic comparisons of survey designs and item quality to build a much-needed cumulative knowledge trajectory in the field of integrity studies.

Fraud in genetic testing: Swindling the system

PurposeHealth care fraud comprises a sizable portion of US health care expenditure and inflicts undue burden on payers, patients, and the health care system overall. The genetic testing industry is rapidly growing, which propagates opportunities for health care fraud. Although federal organizations have highlighted it as an issue, there is limited research exploring genetic testing fraud. MethodsA retrospective review of federal websites, news articles, and a legal database resulted in 42 cases of fraud involving outpatient genetic testing published between February 2019 and December 2023. These cases were analyzed for themes via inductive conventional content analysis. ResultsThemes of fraudulent activity included submission of fraudulent claims, kickback or bribe payments, minimal or no contact with patients for whom testing was ordered for, inappropriate billing and documentation practices, and further actions to conceal fraud. Repercussions imposed on defendants included monetary penalty, imprisonment, business restrictions, and seizure of property. ConclusionHigh rates of medically inappropriate testing in fraud cases highlight the value of genetics experts in ordering or reviewing claims for genetic testing. Examining fraudulent activity in genetic testing can help providers identify and report fraud and provide awareness of optimal health care allocation in the genetic testing industry.