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Moss Adams Business Consultants: Top Five Fraud Tips for
Tribal Governments

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Moss Adams Business Consultants: Top Five Fraud Tips for
Tribal Governments

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Fraud risk is nothing new to tribal governments, but in these challenging economic times, the risk of fraud has increased. Tribal government fraud is a significant issue that affects both tribes and their members. Like all organizations, tribal governments must be prepared to manage these risks and their potential impact.

First, let’s look at some of the facts surrounding fraud. According to the Association of Certified Fraud Examiners’ (ACFE) 2014 Report to the Nations on Occupational Fraud and Abuse:

A typical organization loses 5 percent of its revenue each year to fraud.

Fraud among governmental entities accounted for 10.3 percent of all fraud—the second-highest rate for all industries.

The median loss caused by misappropriation-of-assets fraud is $130,000.

The typical amount of time between the onset of a fraud and its detection is 18 months.

Organizations with a fraud hotline were able to detect fraud 50 percent faster than those without.

Only 3 percent of fraud instances are detected by an organization’s annual audit, making this among the least effective antifraud controls.

In a recent case of fraud perpetrated against a large tribe, the opportunity for fraud was present—and it allegedly allowed the executive director of construction to lead an effort to defraud the tribe of $7 million. This tribe’s lax tone at the top and its lack of effective internal controls and proper procedures cost the organization dearly, and not only in money. But the story doesn’t need to end this way. Preventative measures can save your tribe time, money, and heartache.

Let’s look at the top five tips that can help your tribal government in theprevention and detection of fraud.

STRONG TONE AT THE TOP

Intolerance of fraud by your governing body is a strong deterrent. Elected officials must be required to hold themselves to the highest standards of ethics and integrity—which should be outlined in a clear code of conduct—and deal with fraudsters swiftly and fairly. When the governing body walks the talk, so to speak, those who might consider committing fraud will think long and hard about the consequences of their actions. Conversely, without a strong tone at the top, individuals may feel they have nothing to lose by trying to defraud the tribe.

EFFECTIVE INTERNAL CONTROLS AND POLICIES

Prevention is the most effective fraud-fighting measure. Approach it proactively, starting with a fraud risk assessment, which can then be used to implement control activities that mitigate any risks it identifies. Both preventive and detective controls should be implemented, especially in any area that’s been identified as posing a higher risk of fraudulent activity. Antifraud controls include a large range of activities, including:

Multiple levels of approvals

An audit committee composed of council members and others but not the CFO or others in executive management

Job rotation or mandatory vacations

Timely account reconciliations (at least monthly)

Segregation of duties

Physical security of assets

Background investigations on prospective employees

Antifraud training

An effective, well-trained internal audit function

The ACFE offers a free fraud-prevention check-up test on its Web site to help entities test their fraud health and identify major control gaps. Taking this test can help you address issues before it’s too late.

KEEP DETAILED AND CURRENT ACCOUNTING RECORDS

Inadequate or irregular recordkeeping can keep fraud hidden for months or even years. For fraud to be detected and then proven, you must keep good accounting records and ensure that key accounts—such as cash, investments, and accounts payable—are independently reviewed and reconciled at least monthly. If your records are reconciled only in preparation for your annual audit, your chances of catching fraud are greatly decreased.

SEGREGATION OF DUTIES

Segregation of duties is critical to effective internal control, because it reduces the opportunity and therefore the risk of both erroneous and inappropriate actions. The general rule of duty separation is this: the approval function, the accounting or reconciliation function, and the asset custody function should be separated among employees. If the size of your tribal entity doesn’t warrant this separation, you can implement a more detailed supervisory review of related activities as a mitigating control.

ETHICS HOTLINE OR WHISTLEBLOWER PROGRAM

According to the ACFE’s 2014 Report to the Nations on Fraud and Occupational Abuse, tips were by far the most common way fraud was uncovered in 2014. Employees, as well as other parties, such as customers and vendors, are an invaluable source of information for discovering potential fraud.

However, it’s common for individuals to keep quiet due to a fear of reprisal. Providing individuals with a safe and anonymous method to report suspicions of fraud encourages a beneficial flow of information. It’s important these programs operate independently of management, which can be achieved in several ways. You might, for example, use a third-party vendor to operate your hotline; alternatively, you could establish a neutral party within the organization who reports directly to the audit committee or governing body, such as an ethics or compliance officer.

WE’RE HERE TO HELP

By using these five tips as a starting point, you’ll be able to better protect your tribe from the risk of fraud. Moss Adams also offers a wide range of services aimed at helping your tribe fight fraud, from helping you assess your tribe’s risk of fraud to suggesting comprehensive controls and bringing in our certified fraud examiners to investigate if you believe fraud has been perpetrated. To learn more, contact your Moss Adams professional.

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The benefits of investing in commercial property by Bacall
Development

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The benefits of investing in commercial property by Bacall
Development

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Safety is the main reason why some people invest in commercial property since it's the main interest of many. Based on recent reviews, commercial property will still perform for you even if the economy slows down, unlike in residential property. And when the economy is strong, commercial property increases its value and gives you a stable income.

But if you're still in doubt or just planning to start out in this venture, Bacall Development explains the benefits you can gain from investing in commercial property through the following paragraphs to help you make up your mind. The firm is a full-service commercial real estate company that has been involved in this field for decades.

Strong returns are not a surprise to some when it comes to commercial property. You can gain both income and capital growth in a commercial property since it provides strong and reliable returns. However, making a quick gain shouldn't be your only objective because this endeavor requires great effort and patience. You should take advantage of a growing investment over time where you can get a return consistently above inflation.

Aside from higher returns, commercial property is oftentimes more secure - a crucial point to others that can result in a steady income. Leasing commercial real estate usually ranges from three to ten years as opposed to short-term leases of residential properties.

Because of the mentioned benefits above, reviews state that the risk is lesser if you invest in commercial property than in residential property or the stock market. This data is based on overall analysis of both properties.

According to Bacall Development and its associates, commercial property can catch the attention of different sectors in the economy. Because of the dependence of retail property on consumer spending trends, it has the highest direct relationship to the economy, along with industrial properties. Office buildings are most likely to perform depending on long-term supply and demand. Exposure to various sectors can deliver great benefits to you and to avoid fraud as well.

Acquiring tax benefits is imaginable with a commercial property. Most commercial properties attract handy building allowances as well as depreciation allowances on plant equipment within the building.

Protection against inflation is also one of the benefits of investing in commercial property. Reviews reveal that commercial property has been considered as a good protection against inflation over the years. It has a good record of outpacing inflation over a long period of time.

Investment control? Yes, it's possible. You have a significant level of control over your investment in case you're an owner of a direct property. You have control on various areas such as change of use for the property, disposal, redevelopment, renovations, the terms of the lease, the type of tenant, and upgrading.

Furthermore, you have the ability to add value in a commercial property investment through improvement of the appearance, renovation, lease restructure, subdivision or enlargement, and upgrade. You can further leverage your commercial investments as you improve the property and it grows in value. By borrowing more against your improved equity, you can quickly be in a position to control a sizeable portfolio of properties.

However, Bacall Development needs you to know that there are still disadvantages in owning commercial properties. What are mentioned above could be the total opposite to others based on their individual experience. The firm suggests that you must choose the right commercial property to have a strong capital growth and gain a great rental return. You must know what makes a good commercial property.

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Global Singapore Visa processing tips: Immigration Fraud
— Protect Yourself!

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Global Singapore Visa processing tips: Immigration Fraud
— Protect Yourself!

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Don’t be the victim of a scam

If the offer seems too good to be true, it probably is.

Beware of immigration fraud and scams

You may have seen advertisements that promise work permits and guarantee high-paying jobs in Canada. Some offer scholarships to study at Canadian universities or colleges. Potential newcomers to Canada should be aware that many offers like these are fraudulent. In fact, using the services of people who make such promises may result in your application to Canada being rejected.

Canada’s immigration system is based on fairness. Every application receives equal consideration. No one has special connections, and no one can promise your application will be given special treatment or guarantee that it will be approved.

What you need to know

· You are not obliged to hire a representative, including a consultant, lawyer, Quebec notary or paralegal regulated by a law society, to apply for a visa or for Canadian citizenship, but if you do, choose carefully.

· Representatives do not have special connections with Canadian government officials and cannot guarantee you a visa. Nobody can guarantee you a visa.

· Only Citizenship and Immigration Canada (CIC) officers can decide whether or not to issue a visa. Don’t be tempted into using false documents. It is a serious crime to misrepresent yourself by making false statements or submitting false documents when dealing with CIC. If you do this, your application will be refused. You will also face serious consequences. Depending on the situation, these may include:

1. no entry into Canada for at least five years;

2. a permanent record of fraud in CIC’s database;

3. revocation of your permanent resident status or Canadian citizenship;

4. being charged with a crime; or

5. removal from Canada.

· Do not enter into a marriage that is not genuine in order to obtain permanent residence in Canada. Beware of Internet scams and false websites. The official CIC website is www.cic.gc.ca.

· You will find free information for any type of visa on CIC’s website.

· Processing fees are the same at all Canadian visa offices around the world. Fees in local currency are based on official exchange rates and correspond with the standard fee charged in Canadian dollars.

· Canadian visa offices will never ask you to deposit money into an individual’s personal bank account or to transfer money through aspecific private money transfer company.

· If you have questions, contact CIC or the visa office responsible for your area.

Choosing a representative, a consultant or a lawyer

If you do decide to hire a representative, choose carefully:

· Ask someone you trust to recommend someone;

· Talk to several representatives before you decide which one to hire; check references and find out how long they have been in business;

· Make sure you understand exactly what services they will provide, and how much they will charge you. Get this information in writing.

· Make sure they are authorized by the Government of Canada.

The only people authorized by the Government of Canada to charge a fee to represent or advise you on immigration, refugee and citizenship matters are:

· lawyers and paralegals who are members in good standing of a Canadian provincial or territorial law society;

· notaries who are members in good standing of the Chambre des notaires du Québec; and

· citizenship or immigration consultants who are members in good standing of the Immigration Consultants of Canada Regulatory Council.

The Government of Canada will not deal with unauthorized representatives who charge a fee for their services.

To find out whether the person you are thinking of hiring to represent you is authorized by the Government of Canada, ask if they are members of one of the organizations listed above. You can then check with the organization to make sure the person is a member in good standing. Contact information for all of these organizations can be found on the CIC website at immigration.gc.ca/antifraud.

Once you have chosen a representative, make sure the representative updates you on your application on a regular basis. Remember—you must accept responsibility for all the information in your application whether you complete it or it is completed by your representative. It is against the law to give false or misleading information to Citizenship and Immigration Canada.

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ACL Surgery Recovery Timeline and Expectations by Howard Marans MD

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ACL Surgery Recovery Timeline and Expectations by Howard Marans MD

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Repairing a torn anterior cruciate ligament (ACL) may only require a short time in the hospital or health care facility. In fact, most ACL surgery patients return home the same day of the procedure.

ACL Recovery Timeline

The ACL recovery timeline is a longer process. Listening to the doctor’s after-care procedures and expectations is vital for an optimal outcome. Depending on medical history, each person may have a different ACL recovery timeline.

First Two Weeks

During the first two weeks of the ACL recovery timeline, rest is the main priority to help in the healing process.

- Use crutches to help keep the pressure and full weight off from the newly repaired area.

- Keep leg elevated with the use of a pillow.

- Follow the doctor’s recommendations for exercises to help reduce the chances of blood clots or other negative issues.

- Use either over the counter or prescribed medication to help reduce pain and swelling.

The first two weeks are critical to the healing process. Keeping the entire incision area clean and dry will aid in fighting off infections or other serious health issues. Knowing when to call a health care professional after surgery is a must.

- Bleeding from the incisions will not cease and the bandages cannot contain the flow.

- A red streak or line appears around the incision

- The incision area is producing a discharge.

- The inflammation and swelling proceed down the leg into the calf area.

- The patient has a high fever.

- The pain does not subside with the prescribed medication.

If anything looks out of the ordinary, asking a health care professional will give a patient peace of mind and prevent any harmful consequences. Do not be afraid to ask questions concerning aftercare procedures for ACL reconstruction surgery.

Two to Six Weeks

After the initial resting period in the ACL recovery timeline, the next step is to slowly begin strengthening the area to restore full range of movement.

- Crutches should be no longer in use unless directed by the health care professional.

- Beginning to put full weight on the knee

- Slowly working toward full extension of the knee

- A knee brace may be prescribed to help restrict movement

- If comfortable, driving may be allowed.

- Physical therapy begins

Six Weeks to Six Months

After six weeks in the ACL recovery timeline, the patient will move toward returning to normal activities at a slow progression. By continuing to exercise and develop strength in the knee area, a full range of movement may be achieved.

- The area should be pain-free prior to returning to sports or an exercise routine.

- The orthopedic surgery will need to clear the patient prior to engaging in strenuous activities. Beginning too soon will damage the repair area.

- A brace may be suggested to help keep the knee safe.

ACL Surgery Recovery Timeline and Expectations

For premium results during the ACL surgery recovery timeline, listening to a top rated orthopedic specialist is critical. From the initial consultation through the entire recovery process, Dr. Howard Marans  will guide each patient through the steps of the ACL recovery timeline to achieve each level of expectations in the healing process. Please click below to schedule your consultation or call us at 714.979.8981.

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Dr. Howard Marans: Arthroscopic Surgeon at Your Service

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Dr. Howard Marans: Arthroscopic Surgeon at Your Service

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Anyone who has had an injured knee, or any joint for that matter, realizes the importance of having normally-functioning skeletal system. Just the simple but often-taken-for-granted ability to walk without experiencing knee or ankle pains can be an elusive privilege for many who have severe orthopedic conditions that require surgery. Thanks to medical technological advancement, people who have these conditions can resort to arthroscopic surgery which Dr. Howard Marans routinely undertakes at his clinic.

Arthroscopic surgery simply involves the use of a tiny camera called an “arthroscope” to allow the surgeon to see inside a joint. Thus, the camera enablesDr. Marans to conduct accurate diagnosis of any orthopedic condition and provide the proper treatment of various joint problems. In contrast to open surgery, arthroscopic surgery is a minimally invasive process which is why it is much more preferable than open surgery.

Some of the advantages of arthroscopic surgery include the absence of large incisions, thereby allowing the patient to recover fast even without having to stay in a hospital after the operation. As such, bleeding and infection are also minimized with this kind of procedure. Recovery time is also shorter as a result of the minimal invasive nature of the procedure.

Arthroscopic surgery is used often in injuries involving such joints as the shoulders, knees, hip, wrist and spine, although it can be used for any joint of the body. Ligament tears and damaged cartilage on the knee can be repaired using this procedure. Dislocated or impinged shoulders, including rotator cuff tears can also be healed through this means.

This procedure is frequently used on larger joints to treat certain conditions. Dysplasia of the hips and other conditions, carpal tunnel syndrome of the wrist and herniated discs and other spine conditions are routine procedures done through arthroscopic surgery.

Sticks and stones may break our bones; but the handy camera -- of course, in the presence of an experienced doctor such as Dr. Howard Marans – can undo whatever injury they may cause. Bones may not need a selfie; but a happy and healed patient deserves one after a successful surgery.

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Dr. Richard Isaacs: Big
Pharma has the upper hand 'and they know it' 

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Dr. Richard Isaacs: Big
Pharma has the upper hand 'and they know it' 

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Last updated 05:00, May 10 2015 - The ever-increasing cost of medicines is causing Government and industry concern.  The ever-increasing cost of medicines is causing Government and industry concern.

And as  the price of life-saving medicines soar and pharmaceutical companies show no signs of justifying their costs, the Government is warning that something has got to give.

Pharmac, the Government's drug buying agency,  began funding a key blood cancer drug Thalidomide, manufactured by drug giant Celgene, in 2002. While the true costs of what Pharmac pays are confidential, the list price for the drug in 2002 was $360, based on a daily average dose for a month.

Compare that with a later iteration of the same drug - Lenalidomide - which in 2014 carried a list price of $8353. A third option for blood cancer patients, whose condition might not respond so well to the first two, was Bortezomib, which had a list price of $9742.

The benefits of treating cancer with any of the drugs were similar, and limited studies comparing Lenalidomide and Thalidomide showed no survival difference.

When it came to differing forms of chemotherapy for breast cancer, list prices had risen 443 per cent.

Anthracycline, a common chemotherapy, was listed at $975 in 2002. As two more options came onto the market - Docetaxel, also in 2002, and Trastuzumab, in 2007 - list prices rose to $2488 and $5300 respectively.

A similar trend was also shown across medicines for the treatment of kidney cancer, and lung cancer, rising 411 and 44 per cent respectively.

While all those costs related to the list-price of the medicines, chief executive Steffan Crauzas said Pharmac did not pay that much.

How much less Pharmac paid was confidential, but the increase in the list-price showed an alarming trend that the overall cost of providing New Zealanders access to medicines was becoming more difficult.

Costs were symptomatic of a price-war raging overseas, where the medicines market was not so tightly controlled by a public purchaser.

According to the World Health Organisation, medicines accounted for over half of total health expenditures and were often "unavailable and unaffordable to consumers who need them".

It recommended making some essential medicines exempt from taxation.

Breast Cancer Aotearoa Coalition chair Libby Burgess, who led a campaign for the public funding of breast cancer drug Herceptin, said the problem was the Pharmac model.

She cited Australia, where two separate bodies took care of funding decisions and then purchase of the medicines respectively.

"All of that happens under one roof in Pharmac, which means its very easy for one part of the process to compromise another."

MidCentral DHB Oncologist Dr Richard Isaacs said the prices big pharma was charging was "gobsmacking".

"There's been a lot of criticism of Pharmac over the years, and I was involved in advocating for Herceptin, but I strongly believe now there needs to be a strong focus on the costs that pharma are charging when they introduce new targeted therapies into the market.

"We certainly can't afford all of them and I think our process of carefully assessing the drugs is a good one."

Associate Health Minister Peter Dunne said Pharmaceutical companies needed to justify their costs more.

"I think that there's a real question about how everything starts with several zeros behind it, and think that is a question mark... but it may not solve the issue as far as access to medicines in New Zealand is concerned."

Instead, it was Pharmac that would likely undergo changes in the next 10 to 15 years. Those changes were unlikely to be the kind Burgess was after, however.

"Pharmac are remarkably skillfull... and they are able to put these packages together, which are impressive. But the issue I thought they would have done a little more on, is actually evaluating their decisions; was there a benefit from funding Herceptin, for instance?

"We can be confident in the model at the moment, and in the forseeable future. But that's not going to [last forever]." Dunne said.

"[Drug companies] have got the upper hand, and they know it. At the end of the day, no government is going to deny its citizens access to medicines."

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Kaiser South gets Level II trauma certification -
Richard Isaacs MD

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Kaiser South gets Level II trauma certification -
Richard Isaacs MD

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Kaiser Permanente’s South Sacramento Medical Center has been verified by the American College of Surgeons as a Level II trauma center.

The center got provisional verification by the group last year so it could begin operations, but the process requires reviewers to evaluate the program after it is up and running.

Reviewers conducted another on-site review in March to evaluate trauma center staff, equipment and other resources to make sure they meet national standards. Full verification will be in effect until 2013.

Since opening Aug. 1, the new South Sacramento trauma center has treated an average of 150 patients per month.

“We are extremely proud that the American College of Surgeons has verified that our program meets their stringent standards,” Dr. Richard Isaacs, physician-in-chief at Kaiser Permanente South

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Panama Not on Tax Haven List: Passes Strict DC Test

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Panama Not on Tax Haven List: Passes Strict DC Test

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The Republic of Panama is not included on the District of Columbia’s (DC) list of tax havens for fiscal year 2016. The DC Fiscal Year 2016 Budget Support Act of 2015 defines “tax haven” as a jurisdiction that:

•  Has no effective tax, or a nominal tax on the relevant income

•  Has laws and practices that prevent the exchange of tax information with other governments

•  Lacks transparency

•  Facilitates the establishment of foreign entities without a local presence or impact on local economy

•  Excludes local residents from taking advantage of the tax regime’s benefits

•  Has a tax regime that is favorable for tax avoidance

The government of Panama has recently enacted laws that include stringent controls, supervision, and regulation of its banking, financial, and non-financial sectors.

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The first module is e-Mail 2.0 – As you will probably agree, communication is the blood flow of an organization. Keep it flowing correctly within its predefined communication lines and all is well and progressing; but the moment one starts to mess up the organization’s communication system the organization is doomed.

Therefore, the most important part of the organization is, inevitably, its communication system.TimeMaker’s e-Mail 2.0 is the most advanced tool for managing an organization's communication – this may sound like an overstatement, but I assure you that by the time you will learn how to use thissystem, you will think it is an understatement.

The e-Mail 2.0 module provides total control over all communication items and communication lines inside and outside the organization.