Pass the ACFE Certified Fraud Examiner CFE-Financial-Transactions-and-Fraud-Schemes Questions and answers with CertsForce

Detailed Explanation:

Rationale for Correct Answer:This statement is False. Research in occupational fraud consistently shows that when employees believe there is a strong likelihood of being caught, they are less likely to engage in theft or deviant behavior. Deterrence theory emphasizes that perceived certainty of detection is one of the most effective controls against occupational fraud.

Key Concept:Deterrence through perceived detection.

Comprehensive and Detailed Explanation (Based on the ACFE Fraud Examiners Manual – Financial Transactions and Fraud Schemes)

In the Identity Theft chapter of the Financial Transactions and Fraud Schemes section, the ACFE Manual explains that there are two primary methods of committing identity theft:

Traditional identity theft

Synthetic identity theft

These are listed under “Methods of Committing Identity Theft” (1.803), immediately followed by “Types of Identity Theft Schemes” (1.804) such as financial identity theft and criminal identity theft.

1. Why the correct answer is Traditional identity theft (Option B)

In traditional identity theft, the perpetrator uses the real, complete identity of another person—such as their name, government identification number, and birthdate—to impersonate that person for fraudulent purposes. This is exactly what is happening in the question:

The fraudster uses a real victim’s name, government identification number, and birthdate to open a credit card account in the victim’s name.

This matches the Manual’s categorization where traditional identity theft involves misuse of actual personal identifying information (PII) belonging to a real individual, rather than fabricating an identity. The Manual then explains that this stolen identity is often used in financial schemes, such as obtaining credit cards, loans, or other financial benefits, which falls under financial identity theft as a type of identity theft scheme.

So, in ACFE terms, the method is traditional identity theft, and the scheme type is financial identity theft (using another person’s identity to obtain credit or other financial benefits).

2. Why the other options are incorrect

Option A – New account identity theft

“New account identity theft” is a descriptive phrase sometimes used in practice to describe opening new credit accounts in another person’s name, but the ACFE Manual’s formal categorization focuses on:

Methods of committing identity theft:

Traditional identity theft

Synthetic identity theft

Types of identity theft schemes:

Financial identity theft

Criminal identity theft

Medical identity theft

Insurance identity theft

Tax identity theft

Employment identity theft

Business identity theft

“New account identity theft” is not one of the defined method categories in the Manual; the described conduct is captured under traditional identity theft (method) and financial identity theft (scheme type). Therefore, this option does not align with the ACFE’s terminology tested on the CFE exam.

Option C – Synthetic identity theft

The Manual distinguishes synthetic identity theft as a different method. Under “Methods of Committing Identity Theft” (1.803), it explains that synthetic identity theft involves combining real elements of identity (for example, a genuine government identification number) with fabricated or unrelated information (such as a made-up name, date of birth, or address) to create a partly fictitious identity.

In the question, the fraudster is not creating a hybrid or composite identity. They are using all of the real victim’s identifying information (name, government ID number, birthdate) and posing directly as that person. That is traditional, not synthetic.

Option D – Criminal identity theft

Under “Types of Identity Theft Schemes” (1.804–1.805), the Manual describes criminal identity theft as a scheme where a fraudster gives someone else’s identifying information to law enforcement or in criminal justice contexts, so that the victim’s identity is attached to the criminal record or charges.

Typical examples include:

Giving another person’s name and identification details when stopped or arrested

Causing warrants or criminal records to be issued in the victim’s name

In the question scenario, the fraudster is not interacting with law enforcement or shifting criminal records to the victim. Instead, they are opening a credit card account, which is a financial use of the stolen identity. Therefore, it fits financial identity theft as a scheme type, but traditional identity theft as the method.

Comprehensive and Detailed Explanation From the ACFE Financial Transactions and Fraud Schemes Manual

The ACFE Fraud Examiners Manual (2020 International Edition), under the section on Information Security in Electronic Commerce Systems, describes the three primary security goals that must be achieved to protect users and account holders:

Confidentiality

Integrity

Availability

These three goals form the cornerstone of information system protection and are often referred to as the CIA triad.

1. Confidentiality

Confidentiality ensures that sensitive information is accessible only to authorized individuals. The Manual highlights that e-commerce systems must protect customers’ personal and financial data from unauthorized access.

2. Integrity

Integrity requires that the information in the system is accurate and has not been improperly altered. This prevents fraudulent manipulation of records, transactions, and account balances.

3. Availability

Availability ensures that systems and data are accessible to authorized users when needed. This includes preventing disruptions caused by system failures, denial-of-service attacks, or internal sabotage.

These three goals are explicitly documented in the ACFE Manual as essential security requirements for safeguarding electronic financial systems.

Why Option C is the Correct Answer

“Penetrability of data” is NOT an information security goal.

In fact, it is the opposite of what an information security framework seeks to achieve. No section of the ACFE Manual identifies "penetrability" as a required or legitimate objective. Instead, systems should be resistant to penetration attempts.

Thus, Option C does not belong to the CIA model or any ACFE-described security framework.

ACFE Manual Reference

These concepts are covered in the Financial Transactions and Fraud Schemes section discussing information security objectives for e-commerce environments, which identifies confidentiality, integrity, and availability as the foundational goals of secure systems.

Detailed Explanation:

Rationale for Correct Answer:The Fraud Examiners Manual (2020) highlights document reviews, audit tracing, financial analysis, and inside witnesses as the primary methods of proving corrupt payments. Secret infiltration is not a standard fraud examination technique; it is more aligned with law enforcement undercover operations.

Analysis of Incorrect Options:

A. Taxation inquiries – A valid method to confirm payment sources.

C. Inside witness – Valuable evidence in corruption cases.

D. Tracing payments – Fundamental audit step in proving illicit payments.

Key Concept: Proving corrupt payments — standard audit and investigative methods.

Detailed Explanation:

Rationale for Correct Answer:A false balance occurs when incorrect totals are intentionally carried forward from the journal to the ledger or from the ledger to the financial statements. This is often used as a concealment technique in fraud to make the books appear balanced while hiding irregularities.

Analysis of Incorrect Options:

A. Forced Balance – Involves adding fictitious entries to force accounts into balance.

B. Out-of-balance – Results when entries don’t match, but not specifically from carried totals.

D. None of all – Incorrect since “false balance” is the precise term.

Key Concept:False balance entries as concealment techniques in fraudulent bookkeeping.

Detailed Explanation:

Rationale for Correct Answer:Bribes to purchasing employees often aim to:

Ensure late bids are accepted,

Extend deadlines unfairly,

Or falsify bid logs.Bid-splitting, however, is a scheme performed to avoid approval thresholds and does not require bribery of purchasing employees.

Analysis of Incorrect Options:

A. Receipt of late bid – Real reason to bribe.

B. Extend opening date – Real reason to bribe.

D. Falsify bid log – Real reason to bribe.

C. Ensure bid-splitting – Not a bribery motivation.

Key Concept:Bribery motivations in procurement fraud.

Detailed Explanation:

Rationale for Correct Answer:Loan fraud often involves suspicious or unusual documentation patterns. A change order submitted at the same time as a draw request is a red flag, because it suggests manipulation of project costs to justify larger draws from lenders.

Analysis of Incorrect Options:

A. Missing documents – Could indicate sloppy recordkeeping, not necessarily fraud.

B. Low turnover – Not a fraud indicator.

D. Increasing change orders – Could be suspicious, but not as strong a fraud red flag as simultaneous change order and draw request.

Key Concept: Loan fraud indicators.

Detailed Explanation:

Rationale for Correct Answer: This scheme is a business email compromise (BEC), also known as CEO fraud. Fraudsters impersonate high-ranking executives to trick employees into transferring money or disclosing confidential information.

Analysis of Incorrect Options:

A. Reverse social engineering – Involves the fraudster posing as a helper and then exploiting the victim, not impersonating executives.

B. Executive email attack – A generic term, but the ACFE recognizes BEC as the precise classification.

C. Electronic piggybacking – Refers to unauthorized access through another user’s session, not impersonation.

Key Concept: Social engineering and cyber-enabled fraud – BEC schemes.

Detailed Explanation:

Rationale for Correct Answer: Cash larceny is the theft of cash after it has been recorded in the company’s books. Skimming, in contrast, is theft of cash before recording.

Analysis of Incorrect Options:

B & D – Both describe forms of skimming (unrecorded or understated sales).

C – Kickback scheme is corruption, not cash theft.

Key Concept: Distinguishing cash larceny (on-book theft) from skimming (off-book theft).

Comprehensive and Detailed Explanation

Definition of Upcoding (ACFE Manual Reference)

The ACFE Manual identifies upcoding as a type of health care billing fraud in which the provider submits a claim for a more expensive or more complex service than what was actually provided.

Although the exact term “upcoding” appears within the health care fraud discussions, the broader category is part of Financial Transactions and Fraud Schemes concerning fraudulent billing practices. The manual describes fraud schemes in which the perpetrator:

Bills for services not provided,

Bills for more expensive services than were actually delivered, or

Uses codes that misrepresent the level or nature of medical procedures.

Upcoding specifically involves:

Billing for a higher-cost procedure than what was actually performed, by using a code representing a more expensive service.

Why Option D Is Correct

Dr. Raul advised a patient with a small fracture to use crutches, but he submitted a claim using a code indicating that he placed a cast on the patient.

Actual service: Advice and crutches

Billed service: Application of a cast (more expensive procedure)

This is a textbook example of upcoding, as the provider is using a higher-cost CPT code to obtain greater reimbursement than the service warrants.

Why the Other Options Are Incorrect

Option A – Not Upcoding

Cindy receives a payment to undergo an unnecessary procedure, which is then billed fraudulently.

This is medically unnecessary services fraud, not upcoding.

Option B – Not Upcoding

Dr. Loomis uses three procedure codes instead of one.

This is an example of unbundling, which involves billing separate codes for procedures that should be billed as a single package.

Option C – Not Upcoding

Landon inflates the amount of a medical bill he wants reimbursed.

This is billing inflation or overstatement, but not misrepresentation via coding.

ACFE Manual Supporting Reference

The Manual’s section on fraudulent billing schemes discusses cases where perpetrators misrepresent medical procedures, including using false or inflated codes to obtain higher reimbursements.