Tag Archives: financial crime

Biometrics and Authentication – A new world of possibilities

This article was written 842938_huella_dactilar_y_lectorby Sacha Breite, head of future payments at SIX Payment Services. It originally appeared here on July 20, 2015.

The search for a common, international standard of payment authentication is in full flow.

Governments, retailers, banks and (not least) consumers are all eager to find a means of confirming someone’s identity beyond any doubt, secure from external hacking and technologically reliable.

The situation has become more urgent with the wildfire spread of mobile technology, opening up countless opportunities for remote transactions, but placing a growing burden on payment systems to prevent fraud and theft, both of assets and identities.

So, what are the best ways forward?

Here are some of the key technologies, with an analysis of their pros and cons:

Fingerprints and vein recognition 

Already in common use at border controls and in many smartphones, fingerprint identification has become widely accepted. But concerns over its reliability and security has dissuaded banks from adopting it for payment authentication.

Some consumers fear that their fingerprint hashdata could be copied and used fraudulently, so they have switched back to pin ID. Younger consumers are more relaxed with the technology and ApplePay can be activated using fingerprint ID.

As technology develops and sensors are more widespread, some are concerned that their fingerprint ID could be captured simply by touching something, without realizing. The technology is likely to remain popular, but probably in combination with other forms of ID.

Facial recognition 

Another border control technology which is likely to spread into the commercial world, this once again raises reliability concerns. What happens if one’s face alters its appearance? Can someone be impersonated by showing an image of their face?

A number of extra aspects can tighten security: infrared scanners can tell the difference between a live person and an image; a 3D scan of someone’s head provides further authentication; and iris recognition is becoming more sophisticated.

The new ‘Hello’ function on Windows 10 includes a means of unlocking one’s computer simply by looking at it. So the prospect of going to an ATM, looking at it and then getting cash out, may be possible in future (though some people will object to being filmed, on privacy grounds).

Customers taking ‘selfies’ and using these as authentication, either as a still image or a video, is another emerging form of authentication. Recently MasterCard announced plans to pilot this solution and replace passwords in 3-D Secure protected payments.

Heartbeats

Like our fingerprints and irises, everyone has a unique heartbeat. Using this for identification has the advantage that is it dynamic rather than static and therefore harder to replicate and proves that you are an actual human being.

The technology is part of many current and emerging devices, particularly for sports and fitness use, providing a ready means of integration with other systems, such as transactions or establishing ID.

Wearable technology, whether for health, fashion or communication, will give this type of authentication further impetus. So we can expect to see more of it in the years to come.

Beyond the technologies employed, there are further debates over whose responsibility it should be to develop any common standard. Governments are an obvious place to start, and indeed they have collaborated successfully to introduce border controls using biometric ID.

Yet transactions involving large amounts of money, especially ones using mobile devices, require greater security than this. People are physically present at border points and have to show their passports, so the biometrics are simply an additional security layer.

Most of the initiatives rolled out by governments using biometric ID authentication for health insurance (for example) have failed to work in the commercial sphere.

Card Schemes such as Visa and MasterCard would love to introduce such a system and have it commonly adopted internationally, since it would increase brand loyalty and probably win them new customers.

But so far, the lack of clarity over what kind of technology will be most widely accepted, by governments, consumers and by the legal world, has prevented any major financial service provider taking a leap of faith. Reliability, security and privacy issues remain unresolved.

In some ways, technology is leaping ahead of the best efforts of governments and banks, through applications like Google Street View and Google Image, where individuals can be identified through pictures taken of them without necessarily having their consent. And commercial services such as Amazon, PayPal and eBay have pioneered slimmed-down ID procedures, which may become more widely adopted.

An ever increasing amount of data is being stored on all of us, which will enable identification through many differing avenues. Irrespectively of the current position of biometrics and technology, it is vital for banking and payment infrastructure providers like SIX Payment Services, to provide high levels of security and reliability. In the near future we can expect further innovations to appear in this space, however it is still unclear which  will form the basis of a single global standard, until the dust has settled from the current burst of activity.

Using Link Analysis to untangle fraud webs

Posted by Douglas Wood, Editor.

NOTE: This article originally appeared HERE by Jane Antonio. I think it’s a great read…

Link analysis has become an important technique for discovering hidden relationships involved in healthcare fraud. An excellent online source, FierceHealthPayer:AntiFraud, recently spoke to Vincent Boyd Bryant about the value of this tool for payer special investigations units.

A former biometric scientist for the U.S. Department of Defense, Bryant has 30 years of experience in law enforcement and intelligence analysis. He’s an internationally-experienced investigations and forensics expert who’s worked for a leading health insurer on government business fraud and abuse cases.

How does interactive link analysis help insurers prevent healthcare fraud? Can you share an example of how the tool works?

Boyd Bryant: Link analysis is most often used to piece together different kinds of data from multiple sources–to identify key players, connections between those players and patterns of behavior frequently missed. It can simplify an understanding of the level of involvement of individuals and criminal organizational hierarchies and can greatly simplify visualizing and communicating the operations of complex criminal enterprises.

One thing criminals do best is hide pots of money in different places. As a small criminal operation becomes successful, it will often expand its revenue streams through associated businesses. Link analysis is about trying to figure out where all those different baskets of revenue may be. Insurers are drowning in a sea of theft. Here’s where link analysis becomes beneficial. Once insurers discover a small basket of money lost to a criminal enterprise, then serious research needs to go into finding out who owns the company, who they’re associated with, what kinds of business they’re doing and if there are claims associated with it.

You may find a clinic, for example, connected to and working near a pharmacy, a medical equipment supplier, a home healthcare services provider and a construction company. Diving into those companies and what they do, you find that they’re serving older patients for whom multiple claims from many providers exist. The construction company may be building wheelchair ramps on homes. And you may find that the providers are claiming payment for dead people. Overall, using this tool requires significant curiosity and a willingness to look beyond the obvious.

Any investigation consists of aggregating facts, generating impressions and creating a theory about what happened. Then you work to confirm or disconfirm your theory. It’s important to have tools that let you take large masses of facts and visualize them in ways that cue you to look closer.

Let’s say you investigate a large medical practice and interview “Doctor Jones.” The day after the interview, you learn through link analysis that he transferred $11 million from his primary bank account to the Cayman Islands. And in looking at Dr. Jones’ phone records, you see he called six people, each of whom was the head of another individual practice on whose board Dr. Jones sits. Now the investigation expands, since the timing of those phone calls was contemporaneous to the money taking flight.

Why are tight clusters of similar entities possible indicators of fraud, waste or abuse?

Bryant: When you find a business engaged in dishonest practices and see its different relationships with providers working out of the same building, this gives rise to reasonable suspicion. The case merits a closer look. Examining claims and talking to members served by those companies will give you an indication of how legitimate the operation is.

What are the advantages of link analysis to payer special investigation units, and how are SIUs using its results?

Bryant:  Link analysis can define relationships through data insurers haven’t always had, data that traditionally belonged to law enforcement.

Link analysis results in a visual reference that can take many forms: It can look like a family tree, an organizational chart or a time line. This reference helps investigators assess large masses of data for clustering and helps them arrive at a conclusion more rapidly.

Using link analysis, an investigator can dump in large amounts of data–such as patient lists from multiple practices–and see who’s serving the same patient. This can identify those who doctor shop for pain medication, for example. Link analysis can chart where this person was and when, showing the total amount of medication prescribed and giving you an idea of how the person is operating.

What types of data does link analysis integrate?

Bryant: Any type of data that can be sorted and tied together can be loaded into the tool. Examples include telephone records, addresses, vehicle information, corporate records that list individuals serving on boards and banking and financial information. Larger supporting documents can be loaded and linked to the charts, making cases easier to present to a jury.

Linked analysis can pull in data from state government agencies, county tax records or police records from state departments of correction and make those available in one bucket. In most cases, this is more efficient than the hours of labor needed to dig up these types of public records through site visits.

Is there anything else payers should know about link analysis that wasn’t covered in the above questions?

Bryant: The critical thing is remembering that you don’t know what you don’t know. If a provider or member is stealing from the plan in what looks like dribs and drabs, insurers may never discover the true extent of the losses. But if–as a part of any fraud allegation that arises–you look at what and who is associated with the subject of the complaint, what started as a $100,000 questionable claims allegation can expose millions of dollars in inappropriate billings spread across different entities.

Robbing the Casket, What Happens In Vegas, and Railroad Ripoffs: Selected Financial Crimes Snapshot 12/21/2013

To all of our readers… Have a great Christmas season and see you in 2014!

Posted by Douglas Wood, Editor.  http://www.linkedin.com/in/dougwood

Another case of worker’s compensation premium fraud. You may recall my previous post on this subject. It’s worth reading.

http://manasquan.patch.com/groups/police-and-fire/p/owner-of-wallbased-roofing-company-indicted-for-fraud-and-theft

You’ve heard of robbing the cradle. This is robbing the casket, I suppose…

http://www.13abc.com/story/24279926/funeral-home-owner-charged-with-theft-fraud

He’ll have 8 years to choo choo choose a new way to make a living…

http://newyork.cbslocal.com/2013/12/21/8-years-in-prison-for-former-lirr-conductor-in-fraud-scheme/

What happens in Vegas… Stays in a federal penitentiary.

http://www.lasvegassun.com/news/2013/dec/20/man-gets-11-years-15-million-mortgage-fraud-scheme/

Death Deterrents, Texas Teeth, and ‘The Big Easy’ Money – Selected Financial Crimes Snapshot 11/07/2013

Posted by Douglas Wood, Editor.  http://www.linkedin.com/in/dougwood

Chinese woman sentenced to death for fraud. Ouch. That’s definitely a deterrent…

http://abcnews.go.com/International/wireStory/chinese-woman-sentenced-death-200m-fraud-20785445

70 year old Orthodontist sentenced to two years. Fraud laws in Texas have some real teeth in them…

http://www.kfdm.com/shared/news/top-stories/stories/kfdm_vid_7425.shtml

Think they’ll throw the (school) book at her?…

http://www.philly.com/philly/news/local/20131107_Charter_school_founder_s_fraud_trial_gets_underway.html

New Orleans cops charged. To Protect and Serve (themselves)…

http://www.wwltv.com/news/eyewitness/mikeperlstein/Two-NOPD-officers-have-first-court-date-on-payroll-fraud-issue-231068431.html

Psychics, Housewives, and Weekends with Bernie – Selected Financial Crimes Snapshot 9/26/2013

Posted by Douglas Wood, Editor.  http://www.linkedin.com/in/dougwood

Florida psychic found guilty of fraud. You think she’d have seen this coming, no?…

http://www.sun-sentinel.com/news/local/crime/fl-rose-marks-verdict-20130926,0,4382976.story?page=2

Madoff accountant could be spending more than just weekends with Bernie…

http://www.stamfordadvocate.com/news/article/Greenwich-man-faces-federal-charges-in-Madoff-4847586.php

Real Housewife in Real Trouble.  Teresa Giudice talks about fraud charges…

http://radaronline.com/exclusives/2013/09/teresa-giudice-fraud-charges-crying-andy-cohen/

Medicare fraud trouble in Fargo? Aw geez. Where’s Marge Gunderson when ya need ‘er?

http://www.minotdailynews.com/page/content.detail/id/578432/Wash–doctor-in-ND-court-on-Medicare-fraud-charges.html

Posted by Douglas G. Wood. Click on ABOUT for more information and follow Financial Crimes Weekly on Twitter @FightFinCrime

Prayers, Caregivers, and Breaking Bad – Selected Financial Crimes Snapshot 9/18/2013

Posted by Douglas Wood, Editor.  http://www.linkedin.com/in/dougwood

Does KYC mean Know Your Caregiver?

http://onlineathens.com/breaking-news/2013-09-18/savannah-woman-sentenced-51-months-federal-prison-embezzling-71k-elderly

Another great example of the need for systematic 314(b) programs?

http://www.chicagotribune.com/news/local/suburbs/joliet_romeoville/ct-tl-0926-sw-joliet-financial-crime-20130918,0,464668.story

Breaking Bad?  Financial Crimes Investigator indicted for fraud.

http://www.timesofisrael.com/senior-financial-crimes-investigator-indicted-for-fraud-theft/

Holy Fraud Scheme!  Better say their prayers.

http://greece.greekreporter.com/2013/09/16/sdoe-reveals-monastery-fraud/

Posted by Douglas G. Wood. Click on ABOUT for more information.