Fraud Control BPG
Fraud Control BPG
Fraud Control BPG
Fraud Control in
Australian Government Entities
March 2011
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This Better Practice Guide was prepared by the Australian National Audit Office and KPMG.
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Foreword
Fraud continues to be an ever-present threat to the Australian community, posing significant challenges to
organisations in its prevention and detection. Across business and government it has been estimated that only
a third of fraud-related losses are actually being detected.1
Sound and effective fraud control requires commitment at all organisational levels within an entity. Just as
governance and project management arrangements have evolved to become common practice in government
entities, fraud control strategies need to mature and become an accepted part of the day-to-day running of
entities.
Recent deficiencies in the delivery of high-profile government programs resulted, in part, from a failure to
implement robust fraud control measures early in the life cycle of these programs. This resulted in significant
losses and reputational damage from fraudulent behaviour. A sound understanding by senior management of
the responsibilities and expectations with regards to fraud control, can help ensure the Australian Public Service
(APS) meets community expectations that government services and programs will be delivered with integrity.
In March 2011, the Minister for Home Affairs issued an updated version of the Commonwealth Fraud Control
Guidelines (the Fraud Control Guidelines). These new guidelines are more principles-based, and establish the
fraud control policy framework within which entities determine their own specific practices, plans and procedures
to manage the prevention and detection of fraudulent activities.
This Better Practice Guide is intended to complement the Fraud Control Guidelines, and to augment the key
fraud control strategies referred to in the Guidelines. While this Guide is an important tool for senior management
and those who have direct responsibilities for fraud control, elements of this Guide will be useful to a wider
audience, including employees, contractors and service providers. The Guide also takes account of the fact that
fraud control arrangements need to be tailored to the individual entitys circumstances.
The Guide has been prepared in consultation with the Attorney-Generals Department and should be read in
conjunction with the Fraud Control Guidelines and the APS Values and Code of Conduct. The ANAO would
like to acknowledge the assistance of KPMG in compiling this Guide, the Attorney-Generals Department in
contributing to its content, and the entities that provided material for the case studies and input for other
aspects of the Guide.
Ian McPhee
Auditor-General
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Contents
1. Introduction..................................................................................................................................... 1
2.1. Leadership........................................................................................................................................ 9
2.2. An ethical culture............................................................................................................................. 10
5. Fraud ControlPrevention........................................................................................................... 29
6. Fraud ControlDetection..............................................................................................................51
7. Fraud ControlResponse............................................................................................................ 61
Appendices.......................................................................................................................................... 87
Index..................................................................................................................................................... 95
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Introduction
1.1. The need for effective fraud control strategies
refers to the integrated set of activities to prevent, detect, investigate and respond to fraud and to
the supporting processes such as staff training and the prosecution and penalisation of offenders.
Making sure that appropriate fraud controls are in place, continues to be an important function
in Australian Government entities.3 Notwithstanding the financial and personal cost of fraud, the
reputational damage to entities can be direct and long-lasting. Contemporary management in the
Australian public sector is underpinned by managers and senior executives who are familiar with the
Introduction
Fraud can be defined as dishonestly obtaining a benefit by deception or other means.2 Fraud control
key elements of a robust fraud control framework, including policy, legal and governance requirements.
Fraud control strategies based on a bi-annual preparation of a fraud control plan and fraud risk assessment
are becoming less common. Increasingly, effective fraud control strategies are an integrated response led by the
executive in an entity and embedded in its governance, program design and management. Such a proactive
approach assists entities to manage fraud risk to an acceptable level, mindful of the changing landscape,
source and types of fraud risk that must be assessed and managed.
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Senior executives
The Guide has been developed with the first four chapters being intended as a source of guidance for senior
executives. These introductory chapters provide the legislative and policy framework for fraud control in Australian
Government entities; set the tone for leadership, culture and integrity; and summarise the key strategies necessary
to ensure best practice fraud control is embedded in organisational governance and processes.
Fraud Managers
Fraud Managers have delegated responsibility for fraud control within their organisation. This Guide is a key
reference document to support the Fraud Managers day-to-day business.
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Operational managers
Those operational managers with responsibility for fraud control strategies, such as analysis of management
accounting reports or conducting compliance reviews, should use this document on a regular basis as a
reference point.
Introduction
1
4. ANAO Better Practice GuideFraud Control in Australian Government Agencies, 2004.
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Case studies
The Guide includes case studies and practical examples to assist entities to improve their fraud control
practices. The Guide recognises that fraud control arrangements will vary according to an organisations role,
size, functions and particular characteristics, especially its fraud risk profile.
Introduction
Program management
Because of the growing emphasis on program delivery in the Australian Government, the Guide provides
program-specific assistance on how to manage fraud risks at each critical stage of the program life cycle. This
assistance is provided throughout the Guide, in context with the pertinent fraud control strategies.
Identity fraud
Identity fraud is one of the fastest growing crimes in Australia and costs the Australian community billions of
dollars every year. Guidance on initiatives to combat the rapidly emerging problem of identity fraud is provided in
a dedicated chapter.
1
5
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Key points
Strong executive leadership is integral to effective fraud control within
organisations.
If staff perceive that controls to respond to fraud are not robust or
supported by management, they are much less inclined to report their
observations or suspicions.
To keep astride of emerging fraud risks there needs to be a shift from
traditional fraud control to contemporary fraud control.
The establishment of an ethical culture is a key element of sound
governance and plays an important role in preventing fraud and helping
to detect it once it occurs.
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2.1. Leadership
Leadership and Culture
The realisation of fraud risks in a number of high-profile government programs has resulted in a heightened
expectation that fraud risks will be given appropriate attention in the management of public sector entities. For
this reason, there has been renewed focus on strong and executive leadership to support effective fraud control
within organisations. Poor leadership can lead to a culture of complacency within organisations with respect to
fraud control and management.
Managers are required to demonstrate an observably high level of commitment to the control of fraud. Balancing
fraud control with other high-level corporate and operational responsibilities can be challenging for executives.
An effective organisational governance structure, with clearly defined roles and accountabilities for individuals
and decision-making bodies (for example, the Audit Committee, Executive Board or Program Management
Committee), can assist.
A top-down and bottom-up approach to fraud control can help ensure an organisations policies, governance
structures and processes for managing fraud risks are consistent and mutually reinforcing. Senior executives are
best placed to understand whole-of-organisation issues and risks, and to provide a broad context to fraud risk
assessments and fraud monitoring and evaluation exercises. Table 2.1 provides the types of considerations for
an Executive to be suitably engaged in their organisations fraud control strategies.
What
When
Where
Why
How
Recent studies have identified that a lack of leadership in fraud prevention, detection and response can reduce
the likelihood of fraud being reported to management. If staff perceive that controls to respond to fraud are not
robust or supported by management, they are much less inclined to report their observations or suspicions.5
5. Brown, A J (ed.) Whistleblowing in the Australian Public Sector: Enhancing the theory and practice of internal witness management in public
sector organisations, ANU E Press, Canberra, 2008.
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To keep astride of emerging fraud risks there needs to be a shift from traditional fraud control to contemporary
fraud control (as described below). To achieve this goal, Australian Government entities will be required to
embed key elements of fraud control in organisational governance, leadership and culture. This can be made
possible through senior strategic oversight and leadership, and through effective use of this Guide. Table2.2
illustrates what is required to shift from traditional to contemporary fraud control.
Fraud Manager.
life cycle.
program design.
6. Australian Public Service Commission, Embedding the APS Values: Framework and Checklist, 2003.
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How do senior leaders communicate to employees that conduct consistent with the APS Values and
Are there learning and development programs available to all employees that: address their
responsibilities under the APS Values and Code of Conduct, handling tensions inherent in the APS
Values; develop skills for ethical analysis and reasoning; and provide sources of guidance and direction?
Are all instructions and guidance to employees, including chief executive instructions, people
management rules and guidance, and advice on communications with ministers offices and the media,
consistent with and supportive of the APS Values and Code of Conduct?
What measures are in place to ensure that internal control systems, such as internal audit, fraud control
strategies and risk assessment, are functioning and effective?
Senior executives must ensure the work practices of their organisations are consistent with the principles of the
APS Values and Code of Conduct. Creating a culture in which employees are prepared to report a suspected
fraud and supported when they do so is critical in the ongoing operation of an organisations fraud control
strategy. In terms of fraud detection, the KPMG Fraud and Misconduct Survey 2010 identified that 20 per cent
of reported major frauds were identified by employees.7 The Australian Institute of Criminology has also reported
that the detection of external fraud through discovery by staff members or colleagues was an important method
of detection.8
2
7. KPMG, Fraud and Misconduct Survey 2010, p.12.
8. Australian Institute of Criminology, Annual Report to Government 200708: Fraud against the Commonwealth, AIC, Canberra, 2009, p.36.
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Legislation, Policy
and Governance
Key points
The Australian Governments commitment to protecting its revenue,
expenditure and property from fraudulent activity is articulated in
the Financial Management and Accountability Act 1997 and the
Commonwealth Authorities and Companies Act 1997.
Sections 14 and 41 of the Financial Management and Accountability Act
1997 make it a criminal offence for a Commonwealth officer to misapply,
improperly dispose of, or use public money or property.
Section 26 of the Commonwealth Authorities and Companies Act 1997
makes it a criminal offence for officers of a Commonwealth authority to
use their position dishonestly with the intention of gaining a personal
advantage, to the detriment of the Commonwealth authority.
The Fraud Control Guidelines establish a fraud control policy framework
for Australian Government entities.
Fundamental to sound fraud management is an overall governance
structure that appropriately reflects the operating environment of an entity.
An entitys Audit Committee plays a key role in securing and enhancing
awareness of fraud control across an organisation, including reviewing
managements approach to new and emerging risks during periods of
significant change, such as the implementation of new policies and programs.
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The Australian Government is committed to protecting its revenue, expenditure and property from fraudulent
activity by taking a systemic approach to the management of fraud across the Australian Public Service. This
commitment is articulated in the legal provisions of the:
The governments fraud control policy requirements for FMA Act agencies and CAC Act bodies are outlined in
the Commonwealth Fraud Guidelines 2011 (Fraud Control Guidelines).9
The following sections set out: key elements of the legal and policy framework; the responsible central agencies
within the Attorney-Generals portfolio; and appropriate governance structures for entities.10
behave honestly and with integrity in the course of their employment in the APS;
9. Appendix A lists the key elements of the Australian Governments legislation, policies and guidelines relevant to fraud control.
10. In this document, FMA Act agencies and CAC Act bodies are specifically referred to, where appropriate. As noted previously, the term
entities is used to refer to both types of organisations collectively.
11. The Public Service Act 1999 applies to most FMA Act agencies and some CAC Act bodies. Refer to <http://www.finance.gov.au/
publications/flipchart/index.html> [accessed 15 April 2010].
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disclose, and take reasonable steps to avoid, any conflict of interest (real or apparent) in connection with
their employment in the APS;
not make improper use of inside information or the employees duties, status, power or authority in order
to gain, or seek to gain, a benefit or advantage for the employee or for any other person; and
at all times behave in a way that upholds the APS Values and the integrity and good reputation of the APS.
The Public Service Act provides for the imposition of sanctions on APS employees found to have breached the
APS Code of Conduct. Possible sanctions include: termination of employment; reduction in classification; reassignment of duties; reduction in salary; deductions from salary, by way of fine; or a reprimand.
Figures 3.1 below illustrates the legislative and policy framework for FMA Act agencies.
Figure 3.1: Legal and policy framework for fraud control in FMA Act agencies
Minister for
Home Affairs
Ann
Annual compliance report
Attorney-Generals
Department
ual
com
plia
nce
Minister/
Presiding Officer
Annual Report
(compliant with s.45 FMA Act)
rep
ort
Chief Executive
Compliance report
Survey of compliance with FMA
Act and Commonwealth Fraud
Control Guidelines
Consultation
Australian
Federal Police
Mandatory compliance
Fraud
Control Guidelines
Reg 16A
FMA Regs
FMA Act
Source: KPMG.
16
Australian Institute
of Criminology
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The CAC Act applies to Commonwealth authorities and Commonwealth companies. Commonwealth authorities
are bodies corporate that are established by legislation for a public purpose and which hold money on their own
account (that is, for their own purposes). Commonwealth companies are companies incorporated under the
Corporations Act 2001 that the Commonwealth controls. CAC Act bodies are legally and financially separate
from the Commonwealth.
The CAC Act imposes a number of obligations on officers and employees of Commonwealth authorities to
exercise care and diligence and to act in good faith. As well as this general duty of care, the CAC Act imposes
a number of additional obligations. For example, an officer or employee of a Commonwealth authority must not:
improperly use his or her position to gain an advantage for him or her or someone else (section 24(1));
and / or
In addition, an officer of a Commonwealth authority must exercise his or her powers and discharge his or her
duties in good faith in the best interests of the Commonwealth authority and for a proper purpose.12 An officer
or employee of a Commonwealth authority may be liable to criminal sanctions where these obligations are
breached (section 26).
The CAC Act also contains rules relating to the disclosure of conflicts of interest by directors of a Commonwealth
authority. For example:
a director of a CAC Act entity who has a material personal interest in a matter that relates to the affairs
of the authority must give other directors notice of this interest (section 27F(1)). Subject to specific
conditions, a director who has a material personal interest in a matter that is being considered at a
directors meeting, must not be present while the matter is being considered (section 27J(1)).
3.1.5. Prosecution
While fraud against the Commonwealth may be prosecuted under a number of different Commonwealth laws,
Part 7.3 of the Criminal Code Act 1995 specifically deals with fraudulent conduct against the Commonwealth
and contains a range of criminal offences for fraud. These offences may apply to APS employees, service
providers and contractors, or other members of the public.
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The offences provided in Part 7.3 of the Criminal Code Act 1995 include:
doing anything with the intention of dishonestly obtaining a gain from a Commonwealth entity, or causing
a loss to a Commonwealth entity; and
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Executive leadership
Strong executive leadership from management is integral to effective fraud control within an entity. Managers
should demonstrate an observably high level of commitment to fraud control and the management of fraud, in
addition to ensuring that business processes and internal and external controls are planned and undertaken
following the due consideration of fraud risk exposures. Managers should also ensure that adequate frameworks
are established to support the monitoring and reporting of fraudulent activities and progress in pursuing fraud
control strategies.
Fraud Manager
Clear lines of responsibility in relation to the co-ordination, monitoring, review and promotion of the fraud control
framework need to be established within an entity. This can include the appointment of a central point of contact
for all fraud-related matters. This central point of contact is often referred to as the Fraud Manager.
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A Fraud Manager is the individual with delegated responsibility from the CEO / Board for fraud control within an
entity. A Fraud Managers responsibilities need to be articulated in a fraud control plan and understood by the
entity at large. Where such a position is employed, an appropriate line of reporting is directly to the CEO / Board.
Larger entities, or entities with higher levels of fraud risk, may also establish a specialised in-house fraud unit to
support the Fraud Manager. Fraud units are typically responsible for fraud prevention, detection and response
activities.
Audit Committee
An entitys Audit Committee plays a crucial role in providing independent assurance and advice to the
CEO / Board on the entitys operations, its control regime and its adherence to statutory requirements.14
Key responsibilities of audit committees include:
risk management;
legislative compliance;
external audit.
reviewing managements risk management framework and associated procedures for the effective
identification and management of the entitys financial and business risks, including fraud risks; and
overseeing the process of developing and implementing the fraud control plan, to provide assurance that
the entity has appropriate processes and systems in place to prevent, detect and effectively respond to
fraud-related information.
In some entities, a sub-committee of the Audit Committee may exist which has fraud control as one of its key
oversight responsibilities. Typically these sub-committees are in entities with large benefit payment programs
where business integrity activities are critical and require active management.
3
14. Further information on the role and function of an Audit Committee is available in the ANAO Better Practice GuidePublic Sector Audit
Committees Having the right people is the key, 2005. The ANAO intends to update this Better Practice Guide in 2011.
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Case Study
The Department of Veterans Affairs (DVA) has established a sub-committee of its Audit and Risk
Committee known as the Integrity Sub-committee. The sub-committee focuses on a range of matters
which includes:
reviewing DVAs fraud control plan, and providing assurance to the Audit and Risk Committee
that DVA has appropriate policies, processes and systems in place to capture and effectively
investigate fraud-related information;
reviewing whether management has taken steps to embed a culture which is committed to
ethical and lawful behaviour; and
monitoring adherence to, and potential breaches of, DVAs integrity framework and the internal
code of conduct.
Like the Audit and Risk Committee, the Integrity sub-committee has an independent member. Other
members of the Committee have sufficient, relevant, executive authority to deal with operational issues,
should they arise.
Appendix B provides an aide-memoir designed to assist an Audit Committees consideration of fraud control
through the review of material, discussion or presentations from senior management. This aide-memoir consists of
a series of questions, or high-level prompts, which should be tailored to meet the entitys particular circumstances.
Internal audit
Internal audit provides an independent and objective review and advisory service to:
provide assurance to the CEO / Board that the financial and operational controls designed to manage
the entitys risks and achieve the entitys objectives are operating in an efficient, effective and ethical
manner; and
Internal audit can specifically assist an entity to manage fraud control by providing advice on the risk of fraud,
advising on the design or adequacy of internal controls to minimise the risk of fraud occurring, and by assisting
management to develop fraud prevention and monitoring strategies.
An effective internal audit plan should include a review of those fraud controls designed to address the significant
fraud risks faced by an entity.
15. ANAO Better Practice GuidePublic Sector Internal Audit An investment in assurance and business improvement, 2007, p.4.
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Fraud control and its operation within an entity needs to form part of its overall governance framework. Owing
to its nature and separate statutory reporting requirements, fraud control can often operate in isolation within
an entity. An entitys audit committee can play a key role in securing awareness that fraud control interacts and
links with other governance frameworks across the entity. This understanding provides for fraud and its possible
impacts to be considered at appropriate times when significant changes or decisions occur, for example the
implementation of new policies and programs. Figure 3.2 illustrates how a governance structure might be
arranged for fraud control in an entity.
Audit Committee
Internal Auditor
Fraud Control Plan
Source: KPMG.
Linking the update of the fraud risk assessment to the update of the entitys risk assessment and
business planning processes. This ensures fraud and its possible consequences can be formally
considered in context with other significant risks facing the entity.
Formalising the relationship between fraud control and the operation of any compliance strategies that an
entity has in place. This ensures the compliance strategies are informed by the outcomes of the entitys
fraud risk assessment and fraud control plan.
3
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Is information on the entitys values and code of conduct easily accessible to employees
and included as part of its induction processes?
Does the entity have a conflict of interest policy and is this easily accessible and understood
by employees?
Does the entity have an effective and articulated fraud control framework in place?
Does the entity have a central point of contact for fraud control within the entity?
Does the Audit Committee have a role in overseeing the development and implementation
of the fraud risk assessment and fraud control plan?
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Fraud Control
StrategiesOverview
Key points
Fraud control requires the implementation of a number of key control
strategies which contribute to an effective fraud control framework.
These strategies are interdependent and subject to a cyclic process of
review and enhancement. The strategies are grouped in four key themes.
For these strategies to be effective in the context of an overarching fraud
control framework, each strategy must be subject to active management
and ownership within an organisation.
For most government programs, the prevention, detection and response
elements of the fraud control framework will need to be considered at
each stage of the program. The key is to get the right balance between
fraud risk and control, and to manage the fraud risks while maximising and
enhancing operational performance.
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Fraud control requires the implementation of a number of key control strategies which contribute to an effective
fraud control framework. These strategies are interdependent and subject to a cyclic process of review and
enhancement. The strategies are grouped in four key themes:
Fraud prevention involves those strategies designed to prevent fraud from occurring in the first instance;
Fraud detection includes strategies to discover fraud as soon as possible after it has occurred;
Fraud response covers the systems and processes that assist an entity to respond appropriately to an
alleged fraud when it is detected; and
Fraud monitoring, reporting and evaluation are strategies to provide assurance that legislative
responsibilities are being met, as well as promoting accountability by providing information that
demonstrates compliance with specific fraud control strategies.
For these strategies to be effective in the context of an overarching fraud control framework, each strategy
must be subject to active management and ownership within an organisation. Senior executive oversight
through sound governance arrangements will ensure that each strategy does not operate in isolation, and that
interdependencies are effectively identified and managed appropriately.
The following four chapters provide better practice strategies, systems and processes associated with each
fraud control theme described above.
implementation, such as timeliness, accessibility, and the level of personal information required from recipients.
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Where the risk of fraud is high, it will be appropriate to introduce preventative controls, such as increased
requirements for personal and other relevant information to establish eligibility and the appropriate level of
payment, in order to reduce the potential for fraud.
The method of delivery of a government policy or program can also affect the risk of fraud. For example,
approaches to deliver government services increasingly use third-party providers and make greater use of
e-commerce, including the internet. While these arrangements provide for ease of access to government
services, they may also increase the governments exposure to fraud.
For most programs, the prevention, detection and response elements of the fraud control framework will need
to be considered at each stage of the program. The key is to get the right balance between fraud risk and
control, and to manage the fraud risks while maximising and enhancing operational performance.
For many organisations, the resources available may be limited relative to its fraud control responsibilities. As
such, each entity needs to plan at both a strategic and operational level to best meet its responsibilities within
its allocated resources and budget. This means planning its fraud control activities based on addressing priority
areas and providing for a method of measuring the outcomes of those activities, in terms of their success or
otherwise, in meeting its primary objectives. For fraud control purposes, the focus is on reducing the level of
fraud in the program through integrated strategies around prevention, detection and response.
Table 4.1: Examples of fraud controls at typical life cycle phases of a program
Phase
Policy development, program
design and business case
Procurement strategy
Delivery / implementation /
management
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Fraud ControlPrevention
Key points
Fraud prevention strategies are the first line of defence and provide the
most cost-effective method of controlling fraud within an entity.
Risk management is crucial to fraud control as it guides the development
of an effective fraud control plan.
A fraud policy statement assists employees to understand what fraud is,
their organisations attitude to fraud, and what to do if they suspect fraud
is being perpetrated.
In determining a fit for purpose approach to managing fraud risks, the
resources devoted to preventative strategies should be proportionate to
the fraud risk profile.
Providing information to employees and customers on fraud detected and
action taken indicates that there are consequences attached to committing
fraud and this can act as an effective deterrent.
A separate fraud risk assessment and fraud control plan can be considered
for large or high-risk programs in order to address the fraud risk applicable
to the program.
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Fraud prevention strategies are the first line of defence and provide the most cost-effective method of controlling
fraud within an entity. To be effective, fraud prevention within an organisation requires a number of contributory
Fraud ControlPrevention
elements, including an ethical organisational culture, a strong awareness of fraud among employees, suppliers
and clients, and an effective internal control framework.
Key elements of effective fraud prevention include:
communication about investigation outcomes to demonstrate that allegations and incidences of fraud
are serious and appropriately dealt with.
As with other fraud control strategies, an organisation should align the resources it commits to preventative
strategies according to the fraud exposure of the organisation.
Figure 5.1 illustrates a range of preventative strategies and measures that an entity could consider to manage its
fraud risks. The identified strategies are mapped on a continuum of resource intensity and fraud risk exposure.
The preventive measures contained at the base of the triangle generally represent those preventative measures
that would need to be implemented by any entity to have an effective fraud control framework. Strategies at the
apex of the triangle are more appropriate if an entity has a significant fraud exposure and/or significant resources
to introduce the control.
In determining a fit for purpose approach to managing fraud risks, the resources devoted to preventative
strategies and controls should be proportionate to the fraud risk profile as indicated by, for example, the
materiality, scope, complexity, and sensitivity of possible fraudulent activities. The controls identified and their
associated costs should be considered with respect to the nature and scale of the fraud risks they are designed
to address.
5
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Source: KPMG.
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Source: KPMG.
the operating environment and the entitys relative exposure to external and internal fraud; and
5
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16. ANAO Audit Report No.42 200910, Fraud Control in Australian Government Agencies, Canberra, 2010.
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Fraud ControlPrevention
and/or review
Procurement including
supplier interfaces
management
Exercising regulatory
authority
5
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Risk analysis
Risk assessment
Communcation
and
consultation
Risk assessment
Risk identification
Monitoring
and
review
Risk evaluation
Risk treatment
Several features of the fraud risk management process illustrated above are worth highlighting.
A robust fraud risk assessment process involves communication and consultation with relevant employees
at all levels within an organisation during all stages of the risk management process. This communication should
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address issues relating to the risk itself, its causes, its impact (if known) and the measures taken to treat it.
This approach ensures those accountable for implementing the risk management process and stakeholders
Fraud ControlPrevention
understand the basis of decision-making, and the reasons why particular actions are required.18
Establish the context involves articulating the organisations objectives and the external and internal
parameters to be taken into account when managing risk. This process also sets the scope and risk criteria for
the remaining process.
Identifying fraud risks requires organisations to consider both internal and external fraud risks including,
where relevant to their operations, the potential for international fraud. Organisations can also consider fraud
risks that may emerge in the future, for example, fraud risks arising from a change to an IT system or other
significant changes in business processes. It is also important that fraud risks are taken into account in the design
of a new system or program. Identifying fraud risks at the system and program levels will assist organisations to
assess overall organisational risk, and to reflect these risks in their strategic planning objectives.
As fraud entails dishonesty and deception, the identification of fraud risks requires a sceptical mindset and
involves asking probing questions such as: How might a fraudster exploit weaknesses in the systems of controls?
How could a perpetrator override or circumvent controls? What could a perpetrator do to conceal fraud?
Documenting and assigning ownership of the risks and controls is important. The business area
responsible for managing a particular fraud risk should be identified and the timeframe for implementing any
remedial action should also be clearly documented in risk management plans. An example of a fraud risk
register is provided at Appendix C.
It is also important to monitor and review the fraud risk assessment regularly. The Fraud Control Guidelines
require a fraud risk assessment to be performed at least every two years and coincide with a review of the fraud
control plan. The Fraud Control Guidelines also require that where an entity undergoes a substantial change in
structure or function, or where there is a significant transfer in function (for example, as a result of outsourcing),
the entity must undertake another fraud risk assessment in relation to the changed functions.19 The Fraud
Control Guidelines note that, where appropriate, a rolling program may be introduced to update the fraud risk
assessment more regularly.
An organisation should also actively monitor and review its identified fraud controls. Changes in the effectiveness
or applicability of these fraud controls can impact on the organisations fraud risk assessment to either increase
or decrease fraud risk. An entitys internal audit area would generally be expected to assess periodically whether
the entitys fraud control framework is appropriate and is operating effectively (including monitoring the outcomes
of the fraud control framework). The Audit Committee oversights this process. This role is explored further in
Chapter 8.
18. AS/NZS ISO 31000: 2009 Risk Management Principles and Guidelines, 2009, p.14.
19. Attorney-Generals Department, Commonwealth Fraud Control Guidelines, Canberra, 2011.
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The Fraud Control Guidelines outline the key features of an effective fraud control plan, which have been
included, and enhanced, in Table 5.2 below.
Comments
organisation.
to fraud.
This promotes the link between fraud risk and fraud control.
identified.
an organisation.
Information should be provided on the types and nature of fraud
planning process.
external fraud.
This timeline should include realistic deadlines and include
controls.
The assignment of ownership is critical in establishing
control.
strategies.
Chapter 8 provides further guidance on the necessary monitoring and review activities that should be undertaken
to ensure that the fraud control plan is current and relevant to the needs of the entity.
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The nature and materiality of the internal and external fraud risks faced by small public sector entities could
be expected to be different from the fraud risks faced by large client-facing entities. For this reason, a better
practice principle for small public sector entities is to have fit for purpose mechanisms in place to combat
fraud.
To mitigate the risk of internal fraud occurring, the control structures within small organisations should have a
basic level of preventative controls. For example, avoiding the concentration of key decision areas in the hands
of a single individual is fundamental to the prevention of fraud. Although the separation of duties is a powerful
internal control, it is not always feasible in small organisations. Accordingly, there should be compensating
controls in place such as the Chief Executive or Board approving some transactions.
a fraud risk assessment is undertaken as part of the development or update of its existing fraud control plan;
the fraud control plan covers all aspects of the entity, including its programs and services;
an in-house contact point is assigned for reporting and recording all allegations of fraud; and
the purchasing entity appoints a manager to be responsible for fraud control overall.
While all or part of the fraud control arrangements can be outsourced, entities remain accountable for meeting
their obligations under legislated requirements and the Fraud Control Guidelines.
5
20. Attorney-Generals Department, Commonwealth Fraud Control Guidelines, Canberra, 2011.
39
IMPORTANT UPDATE
Case Study
The Australian Broadcasting Corporation (ABC) last undertook a comprehensive fraud risk assessment
to establish its fraud control plan for 200810. The fraud risk assessment was undertaken by an
external organisation under oversight and direction from the ABCs internal audit department. The key
challenge for the ABC is to maximise coverage to canvass and assess fraud risks as well as using the
fraud risk assessment as a fraud awareness tool, when it:
has a workforce that reflects the diversity of all its operationsmedia, broadcasting,
commercial and retail, online, transmission, IT and support.
The fraud risk assessment involved the use of an all-staff survey which was accessible over the internet
and was hosted by an external organisation. The survey was launched by the Managing Director
and reinforced by periodic pop ups when staff logged into the network. It was completed by more
than 790 staff and was used to assess risks across a range of processes in the organisation and to
collect statistical data by location, division and role while maintaining the confidentiality of individual
respondents.
This approach allowed the ABC to generate fraud risk assessments for each division and the Corporation
overall. As well as informing the annual audit plan, the statistical information was used by the ABCs
internal audit department to tailor and target fraud awareness activity and information.
an assurance that all allegations and investigations will be handled confidentially; and
The policy should also outline what employees should do if they suspect the perpetration of fraud (see Chapters
6 and 7 of this Guide).
40
IMPORTANT UPDATE
register or declare in writing a possible or potential conflict of interest to a manager (for an agency head,
this will be the relevant Minister);
restrict involvement of APS employees in matters in which they have (or are perceived to have) a conflict
of interest;
recruit third parties who do not have an interest (such as probity advisers) to advise on or participate in
the matter;
remove APS employees from involvement in matters in which they have real or perceived conflicts
of interest;
an APS employee may have to relinquish assets or other private interests; and
in rare circumstances, APS employees may need to resign from their employment.
The ANAO Better Practice GuideFairness and Transparency in Purchasing Decisions Probity in Australian
Government Procurement, August 2007, also provides practical guidance on identifying and managing conflicts
of interest and includes a checklist that can be used to identify any potential personal interests that could cause
a conflict of interest.
41
IMPORTANT UPDATE
police criminal history search in all states and any countries where the individual has resided;
reference checks with the two most recent employers and any public sector employer;
checking with any relevant professional licensing or registration board to determine whether an inquiry
by a professional licensing or registration body is pending. Examples include such organisations as
the Institute of Chartered Accountants in Australia, CPA Australia or the relevant State or Territory Bar
Association;
consideration through interview and any necessary follow-up of any employment history gaps and
reasons for those gaps; and
verification of qualifications through an independent source, for example, by calling the relevant
institutions rather than relying on information or documentation provided by the individual.
24. The Australian Government Protective Security Policy Framework is available online at <http://www.ag.gov.au/pspf>.
25. AS 4811-2006 Employment Screening, p.39.
26. UK National Audit Office Tips for minimising the risk of corruption, from NAO Focus magazine, Issue 7 (January 1999).
27. AS 8001-2008 Fraud and Corruption Control, para 3.7.1, p.38.
28. Association of Certified Fraud Examiners, Report to the Nations on Occupational Fraud and Abuse, 2010 Global Fraud Survey, p.5.
42
IMPORTANT UPDATE
It is preferable that fraud awareness training is conducted alongside other related training such as the APS
Values and Code of Conduct, the ethical culture of the organisation including any organisation-related policies
Fraud ControlPrevention
(such as no unauthorised browsing of client records), whistleblowing policy and processes including unlawful
disclosure of official information and compliance with the Privacy Act 1988.
There are a number of different approaches that can be used by organisations in delivering effective fraud
awareness training. The list below outlines a number of approaches which are currently in use in the APS,
including:
producing wall posters, pamphlets, brochures, booklets, bookmarks and fact sheets;
links on entity websites to enable members of the public (including external service providers) to report
suspected external fraud;
including information on fraud matters in weekly communications from the Chief Executive to staff;
The use of these approaches should be considered in the context of the individual organisation to ensure they
are fit for purpose and that measures are matched to the specific risks and available resources of the particular
organisation.
43
IMPORTANT UPDATE
security and organisational profitability associated with good fraud control, and the Australian Federal Police link
ethical behaviour to career progression.
A good fraud awareness training regime includes information on:
the principles of the FMA Act, privacy and confidentiality legislation and awareness, the Public Service
Act 1999 and underpinning expectations such as Values and Code of Conduct and ethical standards
(including how to report fraud and unethical behaviour) and conflicts of interest policy;
what constitutes fraudulent conduct, including practical examples of fraud and the potential benefits
fraudsters seek to obtain (intangible and tangible);
responsibilities for the prevention, detection, investigation and reporting of unethical behaviour including
the roles of the individual, the Fraud Manager and the Chief Executive;
the potential disciplinary consequences for those who engage in unethical behaviour;
the role of the Australian Federal Police and the Commonwealth Director of Public Prosecutions where
serious criminal behaviour is alleged.
Consideration should also be given to the design of specific and ongoing refresher fraud training for employees
who work in areas in which there is a higher risk of fraud.
44
IMPORTANT UPDATE
Case Study
Australian Customs and Border Security have embarked over the last 18 months on the implementation
Fraud ControlPrevention
Customs Z Card
The awareness program also involved the distribution of the Customs Z Card. The Z Card is a credit
card-sized document which contains key information including reporting avenues and the fraud control
framework. Its size allows the Z Card to be kept by the employee at their desk or in a convenient place,
which allows quick referral should the need arise.
delivering services fairly, effectively, impartially and courteously to the Australian public;
implementing fraud control arrangements that meet the equivalent standards of the Fraud Control Guidelines.
30. ANAO Audit Report No.40 200910 Application of Core APS Values and Code of Conduct to Australian Government Service Providers,
Canberra, 2010.
45
IMPORTANT UPDATE
For some programs, non-government service providers operate in a sector where a common set of values and
codes of conduct already exist, possibly as part of recognised sector / industry quality assurance arrangements.
While the APS Values and Code of Conduct provide the benchmark for the delivery of services by the Australian
Government, entities can look to apply appropriate elements of recognised industry codes where these codes
provide equivalent service standards, supplemented where necessary.
Thought could be given to reviewing the service providers fraud control arrangements, inviting attendance to
the purchasing organisations fraud awareness training and requiring the service providers staff to sign a code
of conduct declaration.
checking that the organisations trading address and telephone listing matches its contact details;
confirming that the organisations Australian Business Number (ABN) corresponds to its company
register ABN;
verifying the personal details of directors, including conducting a bankruptcy search and disqualification
search;
confirming the entitys registration with the appropriate chamber of commerce or industry association
(if applicable).
46
IMPORTANT UPDATE
Examples of specific preventative fraud controls that can be applied to one or more identified fraud risks include32:
segregation of duties;
hard coded IT system controls (that is, access restrictions or dollar value limits for processing
Fraud ControlPrevention
transactions);
physical security measures, including the use of safes and physical access restrictions;
the deterrent effect of regular and random quality assurance checks by management to determine the
existence of a service or goods procured;
rotation of personnel in high-risk positions (requiring staff to take regular annual leave and balances not
to accrue to high levels).
a policy of personnel rotation in high-risk positions so that improper relationships are less likely to develop;
multiple open channels of communication with employees, customers, vendors and other third parties to
encourage those parties to come forward if they have any concerns relating to corrupt conduct.
32. Note that some of these controls are also applicable as detective controls.
47
IMPORTANT UPDATE
While an organisation may have a desire to avoid adverse media attention, the public reporting of de-identified
information in relation to fraud investigations serves the following purposes because it:
illustrates contemporary ethical issues and can be used as part of a fraud awareness program;
demonstrates that disciplinary decisions are taken against those found guilty of committing fraud; and
prior to the design / development of the program, in order that the program is designed with minimising
or avoiding fraud risks in mind;
after the program has been developed, but prior to implementation, in order to assess the
appropriateness of the design and the adequacy of the proposed controls;
during the period after implementation of the program, to consider operational practicalities that may
not have been envisaged, to consider actual frauds or complaints occurring, and to consider the
effectiveness of controls in their actual operation;
in the event that material changes are made to the design of the program during its operation, to detect
new frauds that may be possible as a result of changes to policy or procedure; and
during the close-out phase of a program to ensure any new fraud risks created by the closure of the
program are managed.
48
IMPORTANT UPDATE
Fraud risk assessments conducted on this basis will assist the organisation to mitigate fraud risks and reduce the
probability of actual incidents occurring (whether serial or opportunistic) that could cause loss to the organisation.
Fraud ControlPrevention
Will large sections of the population be potential participants in the program? and
The fraud control plan should be revisited on a regular basis and in line with the fraud risk assessment, to
incorporate the impact that changes to the structure of the program may have on the likelihood and consequence
of fraud risks occurring.
5
49
IMPORTANT UPDATE
In identifying the fraud risks, did the entity consider: the entitys role, size and function; any
change in structure or function; external and internal fraud; new and emerging fraud risks;
and the broader organisational risks?
Has a fraud control plan been developed to minimise the impact and likelihood of
identified risks?
Has a fraud policy been issued by the CEO outlining the entitys position on fraud?
Do agreements with non-government service providers consider the applicable elements of
the APS Values and Code of Conduct?
Does the entity ensure that adequate employment screening procedures are implemented?
Does the entity take steps to ensure the bona fides of new suppliers and customers and
periodically confirm these?
50
Does the entity ensure that adequate fraud awareness activities and training are
conducted within the organisation? This should also include external parties such as
suppliers and customers.
Does the entity have a formal process in place for communicating the outcomes of
completed fraud investigations?
IMPORTANT UPDATE
Fraud ControlDetection
Key points
Because no system of preventative controls can provide absolute
assurance, entities should implement systems aimed at detecting fraud.
Passive detection measures are controls or activities that do not require
the active involvement of management but exist as a means by which
fraud is detectable within an organisation.
Active measures are controls or activities that require the assertive
involvement of management and by their nature are designed to detect or
assist in detecting fraud within an organisation.
Fraud detection in programs can include regular supplier reviews, data
mining and analysis, and internal and external reporting mechanisms such
as hotlines, web-based reporting and internal reporting channels.
IMPORTANT UPDATE
52
IMPORTANT UPDATE
All Australian Government entities are susceptible to fraud and no system of preventative controls can provide
absolute assurance. As such, entities should implement systems aimed at detecting fraud as soon as possible
Fraud ControlDetection
after it has occurred, in the event that the entitys preventative systems fail.33
The source of fraudulent activity may be: internal (perpetrated by an employee or contractor of an organisation);
external (perpetrated by a customer or an external service provider); or complex (for example, involve
collaboration between employees, contractors, and external service providers).
Measures to detect internal, external, and complex fraud fall into two main categories, passive measures and
active measures, as illustrated in Table 6.1 below.
Active measures
within an organisation.
In determining a fit for purpose approach to managing fraud risks, the resources devoted to detective strategies
and controls should be proportionate to the fraud risk profile (as indicated by, for example, the materiality, scope,
complexity, and sensitivity of possible fraudulent activities). The controls identified and their associated costs
should be considered with respect to the nature and scale of the fraud risk(s) they are designed to address.
53
IMPORTANT UPDATE
The scope and frequency of management review activities will depend primarily on an assessment of risks and
the effectiveness of ongoing monitoring.
A hotline is a single point of contact for staff members (and others) to report information on suspected
fraud. It gives people a means of contacting the organisation at minimal personal risk. A hotline
arrangement also enables staff to obtain advice and information.
A hotline facility has the advantage of being perceived as being independent of management. Entities
may find it beneficial to outsource the hotline service to a third-party provider.
54
IMPORTANT UPDATE
A hotline facility, while predominantly telephone-based, can also sometimes receive reports via other
channels, such as email or mail.
Fraud ControlDetection
A well-designed hotline provides access to a trained interviewer, operates 24 hours a day, supports a
multilingual capability, provides a phone number that is toll-free, and applies consistent protocols for
gathering and recording relevant information.
Matters reported via the hotline are normally treated confidentially, to the fullest extent possible. It can
provide anonymity, though it is a good idea to obtain the complainants name or as many supporting
details as possible to enable better follow-up of an allegation.
An organisation can use the data on fraud allegations to analyse trends and address emerging risks.
Depending on the size and type of the entity (for example, policy, procurement, revenue collection / payment
administration, service delivery, or regulatory), a range of mechanisms can be used to enable fraud allegations
to be reported, including: a telephone line, manned by an appointed delegate; an email or postal address, which
allegations could be sent to; an electronic mechanism, for example, a form available on the internet that could
be submitted electronically.
An organisations website can provide advice to informants about the kind of allegations that could be referred
to the organisation, including whether the tip-off concerns a member of staff, a customer, or a business. An
organisations website can also facilitate reporting in cases where a member of the public may be reluctant to
talk via telephone.
Case Study
Airservices Australia has established an ethics hotline to allow employees to confidentially report issues
Information received via the ethics hotline is referred to an Ethics Committee. The Committee consists
of the General Counsel, the Manager Security and Crisis Planning, the General Manager People and
Change and the General Manager Audit and Assurance. It assesses the report and decides whether
an investigation is warranted.
If a criminal allegation is received, the Security and Crisis Planning Group conducts an initial assessment
of the allegation. It develops terms of reference which must be signed off by the responsible
General Manager.
All investigations are conducted according to Australian Government Investigation Standards.
A final report is prepared for the responsible General Manager and the Ethics Committee. A briefing
is then prepared for the Airservices Australia Chief Executive Officer with a recommendation on
whether the matter should be referred to the Australian Federal Police, the Commonwealth Director of
Prosecutions or the Airservices People and Change business group for disciplinary action, which may
include termination.
6
55
IMPORTANT UPDATE
monitoring and review activities, focused on employees and customers at risk; and
Table 6.2: Early warning signs for staff and/or workplaces at risk of fraud*
Early warning signs: people
take leave.
39. Section 16 of the Public Service Act 1999 prohibits victimisation of, or discrimination against, an APS employee who makes a whistleblowing
report.
40. Regulation 2.4 of the Public Service Regulations 1999 requires that agency heads establish procedures to manage whistleblowing reports.
The procedures must meet the minimum requirements, as set out in Regulation 2.4.
56
IMPORTANT UPDATE
High overheads.
Fraud ControlDetection
*Adapted from The Audit Office of NSW Fraud Control Volume 2 Strategy and Association of Certified Fraud
Examiners, Report to the Nations on Occupational Fraud and Abuse, 2010 Global Fraud Survey.
regular performance appraisals, mandatory disclosure of interests, assets, hospitality and gifts; and
close monitoring in relation to existing computer data-mining to draw attention to transactions that
appear to depart from established norms.
identification of unusual relationships, for example, employee bank account matches a vendor bank account;
6
57
IMPORTANT UPDATE
assessing the effectiveness of internal controls, for example, password sharing, employees remaining on
the payroll after termination / resignation;
identification of irregular trends over periods of time, for example, supplier favouritism; and
an ability to analyse large volumes of transactions over periods of time rather than relying on
sampling techniques.
Generally, there are two types of data mining / analysis: retrospective review and continuous auditing /
continuous monitoring (CA/CM).
Retrospective review generally entails the extraction of historical data (usually data relating to more than one
year) from the organisations Enterprise Resource Planning (ERP) systems for analysis on a standalone IT system
using data analysis software. Retrospective review tools can vary from a spreadsheet or database to software that
is specifically designed for data analysis with pre-programmed tests such as duplicate payments tests, and an
ability to create tests as required.
CA/CM refers to the collection and analysis of current data on a real or near real-time basis, that is, daily,
weekly, monthly. CA is generally considered to provide the internal auditor with information regarding risk and
controls while CM is generally considered to be a management monitoring function. CA/CM tools can vary from
those which monitor transactions real time (much the same way that banks monitor credit card transactions) to
tools which analyse data near real time that is, daily, weekly, monthly. CA/CM may also be performed using the
in-built functionality in an organisations ERP system.
Compliance reviews
Most entities that collect revenue or administer government payments conduct reviews across the various
revenue and payment types. Based on previous experience, knowledge of their customers, and evidence from
within their systems or from outside information, entities may undertake reviews that examine a recipients
circumstances where there is a perceived risk of fraud. The aim of such reviews is to detect a deliberate error,
omission, misrepresentation or fraud on the part of a customer.
Review activity should be targeted to areas of higher risk, and an entity should pursue the most productive
method for undertaking reviews. Data mining / matching is a cost-effective method of supporting reviews,
including cross-organisational approaches.
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IMPORTANT UPDATE
Organisations need to be mindful of privacy considerations and implement appropriate processes to ensure that
any data mining/matching activities conform to legislative requirements.42
Fraud ControlDetection
discussing alleged fraud with the agencys in-house fraud control unit;
reviewing the need to end the contract for breaches of conditions or non-performance; and
42. Data matching undertaken with external organisations is governed primarily by The Data-matching Program (Assistance and Tax) Act 1990;
and the Privacy Commissioners Guidelines for the Use of Data-Matching in Commonwealth Administration. See Office of the Privacy
Commissioner, Guidelines for the Use of Data-Matching in Commonwealth Administration, February 1998.
43. Attorney-Generals Department, Commonwealth Fraud Control Guidelines, Canberra, 2011.
44. ANAO Better Practice GuideDeveloping and Managing Contracts Getting the right outcome, paying the right price, Canberra, Canberra, 2007.
59
IMPORTANT UPDATE
Audit teams may discover instances of fraudulent activity in the course of conducting internal audits.
Internationally, internal audit has been responsible for detecting 15 per cent of all frauds identified in the
government sector.45 In instances where fraud is detected, it is essential that the matter be reported to the
appropriate party, as noted above.
internal and external reporting mechanisms (hotlines, website and internal reporting channels).
Because some programs can be short-lived, such as those designed to respond to an economic downturn or
a natural disaster, continuous auditing or continuous monitoring will be a more effective detection strategy than
retrospective reviews.
Employees play a significant role in the detection of fraud. Without specific fraud awareness training, employees
may not be able to identify the early warning signs of fraud in a program and will not be equipped to respond
appropriately.
Fraud awareness also extends to participants in the program and an awareness campaign should specifically
refer to an organisations zero tolerance to fraud, how fraud can be reported and how the organisation will
respond to allegations. To obtain information from external stakeholders it is also important that the organisation
consider, should the program be sufficiently significant, establishing a complaints or reporting hotline where
fraud or misconduct can be reported.
Does the entity provide sufficient information to enable employees to recognise the possible
red flags or early warning signs of fraud activity?
Does the entity require active fraud detection measures such as data mining or hot spot
analysis?
Are the entitys reporting mechanisms easily accessible by internal and external parties?
Does the entity use internal audit to actively review its detective control environment?
45. Association of Certified Fraud Examiners, Report to the Nations on Occupational Fraud and Abuse, 2010 Global Fraud Survey, p.19.
60
IMPORTANT UPDATE
Fraud ControlResponse
Key points
Fraud investigation and response are key elements of the overall fraud
control framework and provide stakeholders with reasonable assurance
that perpetrators of fraudulent acts are identified, and appropriate remedies
are consistently applied.
All Australian Government entities that are required to comply with the
Fraud Control Guidelines must also comply with the minimum standards for
investigations set out in the Australian Government Investigations Standards.
Under the Fraud Control Guidelines, relevant entities are required to
investigate minor and routine instances of fraud, irrespective of whether
the outcome of the investigation results in an administrative remedy or
is referred for prosecution consideration. Matters involving serious and
complex fraud must be referred to the Australian Federal Police.
Prosecutions are important in deterring future instances of fraud and in
educating the public generally about the seriousness of fraud.
Entities should be committed to recovering financial losses caused by fraud
through proceeds of crime and civil recovery processes or administrative
remedies.
IMPORTANT UPDATE
62
IMPORTANT UPDATE
Fraud response is a key element of the overall fraud control framework. Fraud response strategies provide
Australian Government entities and external stakeholders with reasonable assurance that perpetrators of fraud
Fraud ControlResponse
forensic services;
document examination;
fingerprint analysis;
DNA;
63
IMPORTANT UPDATE
computer forensics.
Under the Fraud Control Guidelines, relevant entities that have the capacity and the appropriate skills and
resources needed to investigate criminal matters and meet the requirements of the Commonwealth Director of
Public Prosecutions (CDPP) in gathering evidence and preparing briefs of evidence are authorised to investigate
serious or complex offences against the Commonwealth.
having up-to-date policies and procedures relevant to their functions and programs and an investigation
management system, and file management and activity recording procedures in place;
complying with the AGIS definition of an investigation and the related primary purpose for gathering
admissible evidence for subsequent action;
documenting their policies and procedures for handling all aspects of the investigation process
consistent with the AGIS, from initial consideration of an allegation through to successful prosecution of
fraudulent crime and recovery of criminal proceeds; and
clearly identifying the different investigation methodologies for administrative and criminal investigations
and the decision-making in relation to the transition from regulatory / compliance functions to criminal
investigation.
47. At the time that this Better Practice GuideFraud Control in Australian Government Entitieswas being prepared and published by the
ANAO, the AGIS was being updated to reflect experience since it was issued in 2003. While the references to investigation standards in this
Better Practice Guide reflect the essence of the revised AGIS, the Australian Federal Police (AFP) plans to provide the revised AGIS on-line
and, if appropriate, to modify the standards from time to time. Given the specialised nature of fraud investigations, entities should consult
the AFPs website to ensure the currency of their overall approach to the investigation of fraud and to inform their investigation activities.
64
IMPORTANT UPDATE
The Fraud Control Guidelines require relevant entities to have information systems in place, appropriate for the
number and complexity of investigations undertaken, in order to manage information gathered about fraud.
This not only supports sound decision-making at the management level, but also helps entities to identify and
address any systemic issues that are relevant to fraud.
It is good practice for an organisation to record every allegation of fraudulent conduct that is reported to it,
preferably in a central database. This enables proactive analysis of potential fraud hot spots and it can be used
to direct the activities of internal audit. A central database also enables trends and analysis of fraud types to be
undertaken and profiles to be developed based on systemic types of fraud cases.
According to the Australian Standard AS 8001-2008 Fraud and Corruption Control, a fraud incident register
should include:
how the incident was reported to management (anonymous report, line management etc);
Such a register can be used to facilitate an organisations policy for the reporting, analysis and escalation of
all detected incidences of fraud and corruption. This policy should be clear on the actions to be undertaken
following the reporting of an incident.
Case Study
The Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) recently
7
65
IMPORTANT UPDATE
recording of the allegation in an appropriately secure fraud incident register, file and/or electronic case
management system, consistent with the Australian Government Protective Security Policy Framework;
the person responsible for making the initial assessment (the decision-maker) is appropriately trained,
as required by the Fraud Control Guidelines, and the entity provides an appropriate level of managerial
oversight of decision-making;
the obtaining of any readily accessible evidentiary information from within the entity, where the collection
of such evidence would not jeopardise any future investigation, to allow an informed decision on the type
of further action required; and
the need to document the reasons for the decision and what action is intended. The decision as to how
to respond to an allegation of fraud is considered to be a critical decision in the fraud investigation
process and one which needs to be appropriately documented.48
An entity may also make use of a Case Categorisation and Prioritisation Model (CCPM). This tool aids
the decision-maker in making the initial assessment and helps drive transparency and consistency in decisionmaking. The AFP utilises a CCPM for matters referred from other organisations, and entities can consider
adapting the principles in this model for their own decision-making purposes.
As provided under the AGIS, it may be that a preliminary inquiry, or case assessment, is required before a
decision can be made as to how to proceed with the allegation. An initial case assessment is aimed at gaining
sufficient information to be able to determine the subsequent appropriate action and could include: an interview
of the complainant; some level of financial analysis to identify the potential veracity of the allegation; and such
other preliminary steps as necessary to enable the decision to be made.
Relevant entities should ensure that in undertaking any preliminary inquiry, they comply with the AGIS and any
entity direction or protocols relating to the handling of allegations of fraud, including those relating to the use of
coercive powers to collect evidence. Agencies need to provide clear guidance to their investigators about the
use of coercive powers particularly once fraudulent behaviour is suspected and the investigation becomes a
criminal investigation.
It should also be noted that, irrespective of whether the decision is made to undertake a criminal or disciplinary
investigation, the AGIS standards of investigation must be maintained to allow for the possibility of the allegation
becoming more appropriate for criminal investigation. As such, relevant entities must have regard to the Fraud
Control Guidelines and the AGIS, which provide guidance on appropriate investigation competency standards
for Commonwealth employees and investigation service providers (see section 7.1.6).
48. Attorney-Generals Department, Australian Government Investigation Standards, AGD, Canberra, September 2003, Chapter 3.
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IMPORTANT UPDATE
Fraud investigations are conducted to determine the facts relating to specific allegations of fraud, through the
collection and examination of evidence. The AGIS provides guidance and better practice investigation and case
management standards for all investigations. Relevant entities must have in place processes and procedures
that are consistent with, or exceed, the model procedures outlined in the AGIS modules.49
For example, relevant entities must have written procedures regarding:
the process for taking witness statements and conducting interviews with suspects;
the handling of all physical evidence, including property seizure records, and the storage and disposal of
exhibits (there should also be written procedures addressing the audit of the exhibit register as required
by the Australian Government Protective Security Policy Framework);
the use of legislated powers such as the power of arrest, detention, coercion, search warrant execution,
production orders and inspection orders.
Investigators must have knowledge of and the ability to apply the principles and elements of their entitys
standards and written procedures.
A fraud investigation and response decision-making process is represented at Figure 7.1. This decision tree
has been developed to provide an explanation of, and guidance through, the fraud investigation and response
process.
This diagram should not be used as a substitute for the AGIS but rather as a guide to better understand the
critical decisions that need to be made and documented, from the initial assessment of the allegation and
throughout the fraud investigation and response process.
Outsourcing investigations
In some instances, relevant entities will not be sufficiently resourced to conduct an internal investigative response
to allegations of fraud. The establishment of an internal fraud investigations team can be costly and takes time to
implement effectively. This will not be an issue for the larger program delivery and customer service entities, but
for smaller entities (or entities which traditionally focus on policy development), the most cost-effective option
will be to engage external investigations services.
In outsourcing investigation activities, relevant entities must take into account the Fraud Control Guidelines and
the AGIS, which provide guidance on appropriate investigation competency standards for investigation service
providers (see section 7.1.6). It is also beneficial if providers have demonstrated experience in conducting fraud
investigations in an Australian government context, and are sufficiently familiar with the requirements of the
Fraud Control Guidelines and the AGIS.
Notwithstanding an entitys resource constraints with respect to internal fraud response capabilities, all serious
and complex fraud matters should be referred to the AFP in the first instance. In addition, a relevant entity must
consider whether it may still require support from the AFP in the form of assistance to execute search warrants
or in the provision of forensic services (see section 7.1.1).
49. Attorney-Generals Department, Australian Government Investigation Standards, AGD, Canberra, September 2003, Chapter 4.
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Identification of unethical
behaviour (fraud/misconduct/
corruption) is made and recorded
in entity database
Miscoduct only
Potential fraud
INVESTIGATION
Entity should give consideration to the severity of the
following characteristics of the case:
Should the
entity refer the case
to AFP?
Yes
No
Does the entity
require external assistance
with the investigation
No
No
Yes
Investigation must comply
with Australian Government
Investigation Standards (AGIS)
Yes
Conduct investigation
using external staff with
appropriate qualifications
Conduct investigation
using entity staff with
appropriate qualifications
AFP to undertake
investigation and any follow
on action as necessary
Collect and
corroborate evidence
RESPONSE
Decision criteria:
1. Is there a prima facie case for prosecution?
2. Is there reasonable prospect of a criminal
conviction being secured (i.e. evidence beyond
reasonable doubt)
No
Is sufficient
evidence available within the
agency?
Should the
entity
prosecute?
Yes
Is there sufficient
evidence to justify criminal
prosecution?
No
Yes
Example decision criteria:
1. Seriousness of alleged offence
2. Mitigating circumstances
3. Youth, age, intelligence, physical health,
mental health of alleged offender
4. Alleged offenders antecedents and background
5. Passage of time since alleged offence
See Prosecution Policy for further examples
Provide details to
CDPP and assist
as required
RESOLUTION
Is it in the public
interest to proceed with the
prosecution?
No
Yes
Yes
Refer case to
CDPP to proceed
with prosecution
Proceed with
civil remedies
Evaluate cause of
fraud occurrence
Implement any actions identified
to prevent future occurrences
Source: KPMG.
68
Proceed with
administrative
remedies in-house
Recovery of losses
(criminal/civil/administrative)
No
IMPORTANT UPDATE
In deciding to undertake a fraud investigation, relevant entities must have regard to the Fraud Control Guidelines
and the AGIS, which provide guidance on appropriate investigation competency standards for Commonwealth
employees and investigation service providers.
The Public Services Training Package PSP04 offers the following qualifications relevant to fraud investigations:
In addition to appropriate qualifications, a robust internal investigations team should have a good mix of skills
and experience. Depending on the needs of the entity an investigations team could include: ex-law enforcement
officers; lawyers; intelligence operatives; forensic accountants; Information Technology experts, and subject
matter experts for the types of programs and services delivered by the entity (for example, building surveyors,
engineers or social workers).
50. Commonwealth Director of Public Prosecutions, Prosecution Policy of the Commonwealth, CDPP, Canberra, 2008, Section 3.4, p.11.
51. Commonwealth Director of Public Prosecutions, Prosecution Policy of the Commonwealth, CDPP, Canberra, 2008.
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IMPORTANT UPDATE
In addition to the evidentiary requirements for prosecution, the CDPP has the discretion to consider whether it is
in the public interest to prosecute the offender(s). The factors to be considered in assessing whether it is in the
public interest to proceed with a prosecution will vary from case to case, but may include52:
whether the offence has been determined to be serious or trivial in nature based on the entitys case
selection and prioritisation policies;
the age, intelligence, health or any special infirmity of the alleged offender, any witness or victim;
Should there be insufficient evidence to prove an offence to the required criminal standard (beyond reasonable
doubt) or there is sufficient evidence for prosecution but the entity concerned considers that the public interest
does not require prosecution, the CDPP should still be consulted in any matter which involves alleged offences
of particular seriousness. The CDPP should also be consulted whenever the entity has any doubt about what
course of action is most appropriate in the public interest.53
7.2.3. Recovery
Once an investigation is complete an entity should consider recovery action. This may be in consultation with
the AFP or CDPP if criminal charges are pending.
The Fraud Control Guidelines require relevant entities to be committed to recovering financial losses caused
by fraudulent activity through proceeds of crime and civil recovery processes or administrative remedies.
70
IMPORTANT UPDATE
The Guidelines also require relevant entities to institute a general policy that recovery action be undertaken
where the likely benefit will exceed the recovery costs. In this context, benefit is not simply financial, but should
Fraud ControlResponse
include consideration of deterrent value and other non-financial benefits such as public perception and integrity
of entity reputation.
Entities should not underestimate the deterrence value of loss recovery. This is particularly important given that
fraudulent activity is considered to be an economic crime generally involving the weighing of potential benefits
against the risk of discovery and subsequent consequences.54 While recovering losses may in some cases
cost more than the value of the loss recovered, the value of reducing the potential benefit to fraudsters and its
deterrent effect must be considered.
Entities have several options for the recovery of losses, including:
through civil procedures such as a demand for payment or similar, pursued via the courts if necessary
(bankruptcy law can be used to recover losses where the individual has insufficient cash assets);
under the Proceeds of Crime Act 2002 (the Act provides a scheme to trace, restrain and confiscate the
proceeds of crime against Commonwealth Law).
7
54. Becker, Gary, Crime and Punishment: An Economic Approach, The Journal of Political Economy 76, 1968, pp.169217; and Clarke,
Ronald R (ed.), Situational Crime Prevention: Successful Case Studies, Second Edition, Harrow and Heston, New York, 1997.
71
IMPORTANT UPDATE
Case Study
In February 2010 responsibility for closure and finalisation of the Home Insulation Program was
transferred to the Department of Climate Change and Energy Efficiency (DCCEE). One of the key
priorities for DCCEE was the initiation of a robust response to the suspected cases of fraud in the
program. A first step in this response required a post-closure fraud and non-compliance strategy, which
included the identification of fraudulent activity such as claiming for insulation installations which had
not been undertaken.
DCCEE engaged external forensic services to identify installers who had potentially demonstrated
serious non-compliant behaviour. In accordance with the fraud and non-compliance strategy these
installers were then subject to a response which was proportionate to the degree of suspected noncompliance or fraud. The types of responses included fraud investigation, civil debt recovery and referral
to state and territory regulatory authorities.
Another key component of DCCEEs response was the creation of an Investigations and Intelligence
Branch with responsibility for investigating instances of serious fraud identified in the program. The
branch was supported by best practice standards and procedures conforming with the requirements
of the Fraud Control Guidelines and AGIS. In addition, DCCEE negotiated a Joint Agency Agreement
with the AFP which included the out-posting of a dedicated officer to assist the department in referring
serious and/or complex matters to the AFP, and facilitating the conduct of joint entity investigations for
less serious matters.
72
IMPORTANT UPDATE
Fraud ControlMonitoring,
Evaluation and Reporting
Key points
Assessing the performance of fraud control activities is an important
element of an entitys accountability to key stakeholders, such as the
Portfolio Minister, the Attorney-General, clients, the Parliament and the
general public.
Fraud control plans should be subject to regular monitoring and revision,
to ensure fraud controls are implemented effectively and achieving their
intended outcomes.
The reporting of fraud control outcomes can provide a deterrent effect
which will assist an entity in minimising the impact of fraud on its operations.
Evaluations of an entitys fraud outcomes can assist managers to assess
the continued relevance and priority of fraud strategies in light of current
and emerging risks, and ascertain whether there are more cost-effective
ways of combating fraud.
IMPORTANT UPDATE
74
IMPORTANT UPDATE
An effective fraud monitoring, evaluation and reporting regime provides assurance that legislative responsibilities
are being met. It also promotes accountability in responsible areas within entities by providing information that
demonstrates their contribution towards compliance and in achieving entity-specific fraud control strategies.
Assessing the performance of fraud control activities is an important element of an entitys accountability to key
stakeholders, such as the Portfolio Minister, the Attorney-General, clients, the Parliament and the general public.
The ANAOs audit of key aspects of Australian fraud control arrangements in Australian Government entities55
concluded that while there had been an improvement in the level of compliance with the Fraud Control Guidelines
between 2002 and 2009, a key area for improvement was the evaluation of specific fraud control strategies.
the appropriate balance between fraud prevention and detection strategies; and
the relative weighting of entity incentives that focus on reducing the potential losses from fraud in the first
instance, as opposed to discovering fraud after it has occurred.
Analysis can also be undertaken on the effectiveness of established controls through undertaking a cost / benefit
analysis both pre and post-implementation of fraud controls. This can often demonstrate savings made by an
entity where effective fraud controls have been implemented.
Is it up to date?
The fraud control plan should be updated regularly to ensure that the individuals tasked with activities under
the fraud control plan are still the individuals in those key positions. Significant changes should trigger an
update of the entitys fraud control plan to ensure it contains accurate and up-to-date information. As outlined in
Chapter 5, a fraud control plan should be updated at least every two years, or sooner if the entity experiences
significant change.
55. ANAO Audit Report No.42 200910 Fraud Control in Australian Government Agencies, Canberra, 2010.
75
IMPORTANT UPDATE
Is it effective?
Changes including new technologies, changes in organisational operations and the commencement of new
initiatives can render existing fraud controls ineffective or inappropriate. An entity should review its fraud control
plan to ensure it is implemented appropriately and that it remains relevant to the risks being faced.
Testing the effectiveness of a fraud control plan could include:
awareness-raising and training are evaluated and are shown to work well in practice;
cases of fraud are dealt with according to applicable external and internal standards;
information on cases of fraud are used to update the fraud risk assessment and strengthen controls; and
It is appropriate to evaluate the controls identified in a fraud control plan to ensure they are implemented and
achieving the intended outcomes. If the controls seek to minimise significant fraud risks, consideration should
be given to the frequency of the evaluations. Any such review should test the effectiveness of control design
and operation and, if possible, seek to benchmark the entitys fraud performance (and hence the effectiveness
of its controls) against other entities.
The following are examples of benchmarks that might be used for evaluating the effectiveness of the response
elements of an entitys fraud control arrangements:
the timeframes within which allegations of fraud are investigated and fact-finding is completed;
the percentage of fraud investigations that are completed within the timeframes required by AGIS and
internal requirements;
requests by the CDPP for additional evidence to support the alleged criminal offence; and
referrals accepted by the CDPP that are successfully prosecuted (includes convictions that are
not recorded).
a one-off action by a person in a position of privilege (any new person in this position may be subjected
to additional or periodical screening or monitoring);
the inadequacy of internal controls (in this case the controls should be re-evaluated and any deficiencies
remedied), or;
collusion (internal control systems can often be overridden by two or more people acting in conjunction
with one another).
76
IMPORTANT UPDATE
Evaluation activities can be coordinated by a Fraud Manager so that identified deficiencies and/or
recommendations can be applied consistently to similar programs/processes. The outcomes of any hot spot
analysis should also be taken into consideration.
8.2. Reporting
For a fraud control framework to be effectively implemented, both internal and external stakeholders need to
be aware of the outcomes of the fraud control activities undertaken. The reporting of these outcomes can also
provide a deterrent effect which will assist an entity in minimising the impact of fraud on its operations. Timely,
accurate and up-to-date data is critical in this process.
8
77
IMPORTANT UPDATE
Since 200607, the Australian Institute of Criminology has annually collected fraud statistics for the
Commonwealth. Entities are required to answer a questionnaire and this information is consolidated and
included in the Commonwealth Fraud Control Annual Report to Government. The information includes all
matters of suspected fraud, matters under investigation and completed matters, whether the fraud was proven
or not, whether the matter was referred to the CDPP or not, and whether the investigation outcome was a
criminal, civil or administrative remedy.
Similarly, with reporting the outcomes of fraud internally, the public reporting of de-identified information helps
illustrate contemporary ethical issues, it demonstrates that disciplinary decisions are regarded seriously, while
also demonstrating the commitment of the entity to investigate allegations of fraud.
8.2.3. Communication
Once the result of an investigation is known (whether the outcome is a criminal prosecution or an administrative
remedy), as far as permitted by privacy legislation, the entity should consider communicating the outcomes to
staff (employees and contractors) and, where appropriate, the public (customers, clients and suppliers). This
demonstrates that disciplinary decisions are regarded seriously and consistently (key factors in the preparedness
of individuals to report wrongdoing in the future) and also serves to keep fraud prevention in the front of the
minds of staff and/or customers, clients and suppliers.
Proactive media management may also display the entitys attitude and response to fraud positively, thus
encouraging further external reporting as well as maintaining public confidence that fraud is a serious matter
and will be handled accordingly.
Large entities with a significant number of fraud cases should use a communication strategy to plan the reporting
of its various types of fraud in order to ensure the information is effective in targeting the relevant audience.
56. ANAO Better Practice GuideImplementation of Programme and Policy Initiatives Making implementation matter, Canberra, 2006, p.51.
78
IMPORTANT UPDATE
8
79
IMPORTANT UPDATE
80
IMPORTANT UPDATE
Identity Fraud
an Emerging Fraud Risk
Key points
Identity fraud has been defined as the gaining of money, goods, services
or other benefits or the avoidance of obligations through the use of a
fabricated identity, a manipulated identity, or a stolen / assumed identity.
In response to the threat of identity fraud the Council of Australian
Governments agreed to a National Identity Security Strategy, a crossjurisdictional, whole-of-government approach to combat the misuse of
stolen or assumed identities.
The Australian Crime Commission manages the Australian Identity
Protection Register, which captures the details of fraudulent identities from
participating law enforcement entities.
IMPORTANT UPDATE
82
IMPORTANT UPDATE
Identity fraud has been defined as the gaining of money, goods, services or other benefits or the avoidance
of obligations through the use of a fabricated identity, a manipulated identity, or a stolen / assumed identity.57
While the term identity fraud has gained prominence throughout the last decade, the fraudulent use of identities
has been in existence for some time. For example, submitting a fraudulent claim for social security benefits in
the name of a deceased relative or opening a bank account in a false name.
In 2007, an identity fraud report issued by the United Nations58 stated that a substantial amount of identityrelated crime is associated with economic fraud, as a means of avoiding fraud prevention measures and avoiding
criminal liability and, in most cases, as a means of deception central to the fraud offence itself.
In response to the threat of identity fraud and identity-related crime and its consequences, the Council of
Australian Governments (COAG) agreed in 2005 to develop and implement a National Identity Security Strategy.
biometric interoperability.
The IGA established the National Identity Security Coordination Group (NISCG)comprising representatives
from the Commonwealth, states and territoriesto develop the NIS Strategy. Work to develop the NIS Strategy
has led to the creation of several best practice / reference guides to improve identity management practices.
These initiatives include the development of the:
Gold Standard Enrolment Framework as a benchmark for organisations designing and revising enrolment
processes. The Framework is applicable to organisations requiring a high level of assurance of a persons
identity before issuing government documents which function as key credentials of proof of identity.
57. Australian Centre for Policing Research, Standardisation of definitions of identity crime terms: A step towards consistency, Report Series
No 145.3, March 2006, p. 13.
58. United Nations, Results of the second meeting of the Intergovernmental Expert Group to Prepare a Study on Fraud and the Criminal Misuse
and Falsification of Identity, E/CN 15/2007/8, p. 5.
59. Attorney-Generals Department, National Identity Security Strategy [internet], available from <http://www.ag.gov.au/www/agd/agd.nsf/
Page/Crimeprevention_Identitysecurity#q1> [accessed 3 December 2009].
9
83
IMPORTANT UPDATE
Security Standards for Proof-of-Identity Documents as a guide for organisations wishing to consider
improving the physical security features of key proof-of-identity documents.
Document Verification Service (DVS) to improve the ability of government organisations across
jurisdictions to verify proof-of-information documents. The DVS is a secure, online system which verifies
the accuracy and currency of proof-of-identity documents in real time. While the DVS provides a higher
level of assurance for organisations enrolling new clients for services, such as Centrelink and the
Australian Taxation Office, it is unable to be fully implemented until protocols and agreements are in place
with all States and Territories.
Data Matching Better Practice Guidelines to provide practical advice for data matching practitioners and
lead to improved data matching performance and improved data quality.
Gold Standard e-Authentication Requirements to guide authentication for clients for electronic
transactions where the identity risks associated with the transaction require a high level of assurance.
Organisations can obtain further information regarding the strategies by accessing the Commonwealth
Attorney-Generals website on Identity Security.60
facilitate cooperation and coordinate the exchange of identity fraud information and intelligence between
organisations for the purpose of law enforcement, the protection of public revenue and informing relevant
administrative decisions.
A number of law enforcement organisations, including the Australian Crime Commission, Australian Federal
Police, Department of Immigration and Citizenship, Australian Customs and Border Protection, and State Police
are also working together as part of the Identity Security Strike Teams. The purpose of the strike teams is to
target organised identity crime syndicates.
60. In 200910, the ANAO completed its performance audit of the coordination of the development of the National Identity Security Strategy by
the Attorney-Generals Department.
84
IMPORTANT UPDATE
In recognition of the fact that a purpose of identity fraud is to avoid detection, organisations should ensure that
when implementing fraud prevention and detection strategies, consideration is given to the risk of identity fraud.
The extent of the fraud prevention and detection strategies will depend on:
the risk posed by identity fraud on the activities of the organisation; and
the risk posed to others (whether government, business or individuals) through the organisation issuing a
proof-of-identity document to a fraudster which could be used to commit identity fraud.
In addition to the fraud prevention and detection measures discussed in previous chapters, the following are
some fraud prevention and detection measures organisations might consider to minimise the risk of identity
fraud.
Document verification
A strategy for assisting with the detection of identity fraud is checking the authenticity of a government document.
A common technique for fraudsters is the creation of false documentation. The Document Verification Service
developed through the NIS Strategy can assist with confirming the authenticity of government documents. The
Document Verification Service is expected to expand the number of Commonwealth and state organisations
through which checks can be made as more organisations, states and territories sign up to the process.
Data matching
A strategy for assisting with the detection of identity fraud is matching entity data with other Commonwealth
and state organisations data. Data matching allows information from a number of sources to confirm the
legitimacy of a person and/or data. Organisations should consider the need to source anothers data, and
options for interrogating the data. The Data Matching Better Practice Guidelines developed through the NIS
Strategy can assist.
Integrity of data
While the strategies above may assist with preventing and detecting identity fraud, this is only as useful as the
data which is maintained by an organisation. If an organisations data is not accurate and up-to-date, this will
create opportunities for fraud to be committed. It is recommended that organisations continually review the
currency and accuracy of their data.
85
IMPORTANT UPDATE
Case Study
Through careful interrogation of information systems data, Centrelinks Fraud Intelligence team were
able to identify a person using four false identities, in addition to their own, to obtain Centrelink benefits.
The person claimed two sets of twins for each false identity (a total of 16 children), one set of false twins
in their own name, and their two real children (in total 20 children).
The person worked in a hospital and had access to documentation which could be provided to Centrelink
as proof of the birth of a child. In addition, the person produced copies of false death certificates (of
alleged spouses) and passports as proof of identity, and fraudulently certified the documents as true
using the name of a bogus solicitor.
The person opened bank accounts in the false names using the same fraudulent identification, and
used different post office boxes for each claim (a total of five PO boxes).
Centrelink commenced surveillance of the person for the purpose of obtaining evidence linking the
person to the false identities. Centrelink referred the person to the Australian Federal Police, who
executed search warrants on the persons homes, post office boxes and banks.
During an interview the person admitted to their actions, was subsequently charged and pleaded guilty
in court. The total amount of the fraud exceeded $600000.
86
IMPORTANT UPDATE
Introduction
Appendices
1
87
IMPORTANT UPDATE
88
IMPORTANT UPDATE
Appendix A
Legislation and policies relevant to fraud control
Appendices
In addition to the Fraud Control Guidelines, the legislative framework for managing fraud incorporates a number
of Commonwealth Acts, regulations and policies. The key elements of this framework are listed below.
Public Service Act 1999, including APS Values and Code of Conduct
Commonwealth policies
89
IMPORTANT UPDATE
Appendix B
Audit Committee fraud control aide-memoire
Governance arrangements
Does the entity have an appropriate fraud incident register and associated procedures in place to
capture and effectively investigate fraud-related information?
Does the entitys fraud control framework integrate with the entitys risk management and
compliance frameworks?
Is the fraud control framework adequately supported by sufficient instructions and guidance for
employees?
Does the entity have an appropriate fraud awareness and ethics training process in place and is
this supported by a robust Fraud Policy and Code of Conduct?
Is the fraud risk assessment linked to the entitys risk assessment and business planning process?
Have key controls been identified and established to address all identified fraud risks?
Where shortcomings have been identified, have strategies been identified to mitigate these?
Have the key fraud risks been considered in the context of the entitys internal audit plan?
Is the entitys fraud risk assessment and fraud control plan current and up-to-date?
Is there a formal process in place to regularly review the entitys fraud risk assessment and fraud
control plan?
90
IMPORTANT UPDATE
Appendix C
Example of a fraud risk register
The fraud risk is described, ensuring that both the cause and impact of the fraud risk
description
The fraud risk factors are those conditions or actions which are most likely to cause
Appendices
Fraud risk
the fraud risk to eventuate. This will generally be a brief list of likely scenarios that
could occur.
Inherent
The inherent likelihood provides an indication of how often an identified risk might
likelihood
eventuate in the absence of any controls. This is generally measured using a fivepoint scale (that is, almost certain, likely, possible, unlikely, rare).
Inherent
consequence
Inherent risk
The inherent risk rating provides a ranking for an identified risk once the likelihood
rating
and consequence of the risk has been considered in the absence of any controls.
This is generally measured using a five-point scale (that is, severe, high, medium,
low, very low).
Key controls
The key controls refer to those controls currently established within the entity to
identified
minimise the likelihood and consequence of the identified fraud risk eventuating.
Residual
The residual likelihood provides an indication of how often an identified risk might
likelihood
Residual
consequence
Residual risk
The residual risk rating provides a ranking for an identified risk once the likelihood
rating
and consequence of the risk has been considered after taking into consideration the
effectiveness or otherwise of the existing controls. This is generally measured using a
five-point scale (that is, severe, high, medium, low, very low).
The fraud risk owner is the individual / group within the entity with accountability for
managing the identified fraud risk.
Action required
This relates to the identification of any further actions that the entity must undertake
in relation to the identified fraud risk (that is, new controls to be established).
91
IMPORTANT UPDATE
Appendix D
Recent ANAO audits related to fraud control
Australian National Audit Office, Audit Report No.10 201011 Centrelink Fraud Investigations, Canberra, 2010.
Australian National Audit Office, Audit Report No.42 200910 Fraud Control in Australian Government
Agencies, Canberra, 2010.
Australian National Audit Office, Audit Report No.29 200910 Attorney-Generals Department Arrangements
for the National Identity Security Strategy, Canberra, 2010.
Australian National Audit Office Audit Report No.34 200809 The Australian Taxation Offices Management of
Serious Non-Compliance, Canberra, 2009.
Australian National Audit Office Audit Report No.7 200809 Centrelinks Tip-off System, Canberra, 2008.
Australian National Audit Office Audit Report No.42 200708 Management of Customer Debt Follow-up Audit,
Canberra, 2008.
Australian National Audit Office Audit Report No.8 200708 Proof of Identity for Accessing Centrelink
Payments, Canberra, 2007.
Australian National Audit Office Audit Report No.43 200506 Assuring Centrelink PaymentThe Role of the
Random Sample Survey Programme, Canberra, 2006.
Australian National Audit Office Audit Report No.29 200506 Integrity of Electronic Customer Records
(Centrelink), Canberra, 2006.
Australian National Audit Office Audit Report No.4 200405 Management of Customer Debt (Centrelink),
Canberra, 2004.
Australian National Audit Office Audit Report No.14 200304 Survey of Fraud Control Arrangements in APS
Agencies, Canberra, 2003.
92
IMPORTANT UPDATE
Appendix E
Bibliography
Appendices
Association of Certified Fraud Examiners, Report to the Nations on Occupational Fraud and Abuse, ACFE,
Austin, 2010.
Attorney-Generals Department, Commonwealth Fraud Control Guidelines, Canberra, 2011.
Attorney-Generals Department, Fraud Control in Australian Government Agencies, AGD, Canberra, 2004.
Attorney-Generals Department, Commonwealth Organised Crime Strategic Framework: Overview, AGD,
Canberra, 2009.
Australian National Audit Office, Better Practice GuidePlanning and Approving Projects an Executive
Perspective, ANAO, Canberra, 2010.
Australian National Audit Office, Better Practice GuideFairness and Transparency in Purchasing Decisions
Probity in Australian Government Procurement, ANAO, Canberra 2007.
Australian National Audit Office, Better Practice GuidePublic Sector Internal Audit an investment in
assurance and business improvement, ANAO, Canberra, 2007.
Australian National Audit Office, Better Practice GuideDeveloping and Managing Contracts Getting the
right outcome, paying the right price, ANAO, Canberra, 2007.
Australian National Audit Office, Better Practice GuideImplementation of Programme and Policy Initiatives
Making implementation matter, ANAO, Canberra, 2006.
Australian National Audit Office, Better Practice GuidePublic Sector Audit Committees Having the right
people is the key, ANAO, Canberra, 2005.
Australian National Audit Office, Better Practice GuideFraud Control in Australian Government Agencies,
ANAO, Canberra, 2004.
Australian National Audit Office, Better Practice GuidePublic Sector Governance, Guidance Paper No. 3:
CAC Boards, ANAO, Canberra, 2003.
Brown, AJ (ed.), Whistleblowing in the Australian Public Sector: Enhancing the theory and practice of internal
witness management in public sector organisations, ANU E Press, Canberra, 2008.
Commonwealth Director of Public Prosecutions, Prosecution Policy of the Commonwealth, CDPP, Canberra,
2008.
Crime and Misconduct Commission Queensland, Fraud and Corruption Control, CMCQ, Brisbane, 2006.
Deloitte, Antifraud Programs and Controls, Deloitte, Boston, 2009.
HM Treasury, Managing the Risk of Fraud, HM Treasury, London, 2003.
HM Treasury, Tackling External Fraud, HM Treasury, London, 2010.
Independent Commission Against Corruption, Fighting Fraud: Guidelines, ICAC Sydney, 2000.
93
IMPORTANT UPDATE
Institute of Internal Auditors, the American Institute of Certified Public Accountants and Association of Certified
Fraud Examiners, Managing the Business Risk of Fraud: A Practical Guide, Austin, 2008.
Independent Commission Against Corruption, Fighting Fraud: Guidelines for State and Local Government,
ICAC, Sydney, 2002.
KPMG, Preparation of a Better Practice Guide on Fraud Control in Australian Government Agencies, KPMG,
Canberra, 2009.
KPMG, Fraud and Misconduct Survey 2010, KPMG, Melbourne, 2010.
KPMG, Fraud Risk Management, KPMG, Canberra, 2006.
National Audit Office, Tips for Minimising the Risk of Corruption, NAO, London, 1999.
Parliamentary Joint Committee on the Australian Commission for Law Enforcement Integrity, Inquiry into the
Operation of the Law Enforcement Integrity Commissioner Act 2006, Senate Printing Unit, Canberra, 2010.
SAI Global, Risk Management Principles and Guidelines, SAI Global, Sydney, 2010.
SAI Global, Fraud and Corruption Control, SAI Global, Sydney, 2008.
Smyth, S and Bray, G, Licensee Fraud, Australia Post, Canberra, 2009.
Steinhoff, J, Forensic Auditing: A Window to Identifying and Combating Fraud, Waste and Abuse, Journal of
Government Financial Management, Vol 57, 2008.
The Audit Office of New South Wales, Fraud Control Improvement KitMeeting Your Fraud Control
Obligations, Sydney, 2006.
The Audit Office of New South Wales, Fraud Control: Current Progress and Future Directions, Sydney, 2005.
US General Accounting Office, Strategies to Manage Improper Payments, GAO, Washington, 2001.
94
IMPORTANT UPDATE
Introduction
Index
1
95
IMPORTANT UPDATE
96
IMPORTANT UPDATE
fraud surveys, 34
recent audits, 92
Australian Standards see AS...; AS/NZS...;
Australian Government Investigations Standards
authentication requirements, 834
B
benefits of loss recovery, 71
Better Practice Guide, 25, 41, 59
checklists, 24, 50, 60, 72, 79
Bibliography, 934
Boards of Directors, 20
C
CAC Act see Commonwealth Authorities and
Companies Act 1997
CA/CM (continuous auditing / continuous
monitoring), 58
case assessments, preliminary, 66
Case Categorisation and Prioritisation Model
(CCPM), 66
case studies, 5
ABC fraud surveys, 40
Airservices Australia ethics hotline, 55
Attorney-Generals Department, 19
audits, 58, 92
Index
administrative remedies, 70
97
IMPORTANT UPDATE
civil remedies, 70
customers, 32
codes of conduct
identity fraud, 85
Commonwealth authorities, 17
Commonwealth Authorities and Companies Act
screening, 467
Customs Z Card case study, 45
ANAO audits, 19
data integrity, 85
Commonwealth companies, 17
19, 6970
Commonwealth Fraud Control Guidelines, 23, 15
applicability of, 18
monitoring and reviewing fraud risk, 37
objectives of, 18
policy framework, 18
Directors, 20
communication
documenting risks, 37
duty of care, 17
to program staff, 49
risk management process, 367
complex fraud
detection, 53
e-commerce, 1, 28
investigation, 634
compliance reviews, 58
employees, 3
allegations by, 54
screening of, 42
contract management, 59
contractors, 3, 59
98
IMPORTANT UPDATE
Executive, 2, 9, 20
outsourcing, 39
Index
strategies, 19
fraud
defined, 1, 18
financial losses, 77
investigations, 639
perpetrators of, 2
by employees, 54
by external parties, 54
identity fraud, 85
program staff, 49
framework, 34
99
IMPORTANT UPDATE
fraud surveys
Australian Institute of Criminology, 19, 53, 78
J
justification for fraud, 20
L
law enforcement initiatives in identity fraud, 84
leadership, 34, 7, 910, 201
good faith, 17
structures, 23
losses due to fraud, 701, 77
M
management see Executive; leadership
H
high-risk areas, 467, 49
historical data analysis, 58
Home Insulation Program case study, 72
hot spot analysis, 57, 65
hotline facilities, 545
N
National Identity Security Strategy (COAG), 834
non-government service providers, 456, 59
operational managers, 3
information-sharing, 59
organisation size, 39
integrity of data, 85
and evaluation
100
ownership of risks, 37
IMPORTANT UPDATE
management
retrospective review, 58
reviewing activities, 37, 569
perpetrators of fraud, 2
risk registers, 91
routine fraud, 63
Index
screening employees, 42
small entities, 39
R
rationalisation for fraud, 20
recording fraud (registers), 65
recovery action, 701
red flags (early warnings), 567
referrals to AFP, 634, 67
T
technology in service delivery, 1, 28
tip-off facilities, 545
traditional fraud control, 10
training, 69
see also fraud awareness training
W
warning signs, 567
whistleblowing, 56
101
IMPORTANT UPDATE
www.anao.gov.au