More fraud investigation tips from Deloitte's Mike Little

Part 2 of an exclusive interview with FierceHealthPayer: Anti-Fraud
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This is the second segment of a two-part interview with Michael E. Little (pictured), a senior manager in the forensic practice of Deloitte Financial Advisory Services, LLP in Philadelphia. He has 35 years of investigative experience focused on fraud in government healthcare programs, white collar crime and internal fraud.

In part one of this exclusive interview, Little spoke about early signs of significant fraud cases, evidence preservation and interviewing. Here, he shares additional fraught fighting insights with FierceHealthPayer: Anti-Fraud, including how to handle employee involvement in fraud schemes.

FierceHealthPayer: Anti-Fraud: What are some costly investigative missteps special investigations units should avoid?

Mike Little: One misstep is operating in a siloed environment. Investigative units can be too insular and lack strong working knowledge of the rest of their organization and/or the investigative community at large.

So join anti-fraud task forces. It can also be very helpful to connect with experts in key content areas. Sometimes that's as simple as talking to a knowledgeable clinician about what appears to be a significant allegation, since a nonclinical investigator might not know enough about the issue to ask good questions or know what's significant.

Another mistake is underestimating an allegation's potential to be a major issue. An SIU may not think their company can be the target of a major health insurance fraud. But criminals don't care whom they defraud; they look for weaknesses and ways to take advantage. Just as underestimating allegations is a mistake, SIUs should also be careful of overestimating issues.

Overall, investigating allegations is a skill that comes from knowledge, experience and keeping an open mind about an issue's potential.