The BIOCLAIM™ Solution

So far, the public awareness, or rather the public concern, in Medicaid fraud, let alone Medicaid fraud in child welfare has been dearth. Little or nothing comes up in the media acknowledging this issue even exists. The most I have come across is a policy position from the White House and a Wall Street Journal article.

Then there are state audits all over the nation identifying fraud.

It is such a simple task for one to stand and call out a problem, but such a grand endeavor to create a solution and present it.

Michigan Senators have sadly attempted to generate a solution to Medicaid fraud in child welfare. The policy offering was so embarrassingly pathetic, it has become a billboard announcement that the state is not doing what it receives federal funding for.

Then, I found logic in a viable solution that is feasible.

The U.S. patented devices and process is called BIOCLAIM™.

Without providing a lecture on biometric technology, I will cut to the chase and provide an except from the website:

The problem is healthcare fraud. Phantom billing, up-coding, card swapping and medical identity theft are the most pervasive types of fraud resulting in estimated losses between 60-220 billion dollars per year.

Other biometric and smartcard company products do not offer a complete solution to healthcare fraud. Most products rely on the front desk to stop a fraudulent transaction. BIOCLAIM™ removes the reliance on the people who are often part of the fraud and creates an auditable technological record.

BIOCLAIM™ is the solution to healthcare fraud.

BIOCLAIM™ is a comprehensive solution to healthcare fraud.

It was at this point I was brought to my knees in the brilliance of the the perfect solution to Medicaid fraud in Child Welfare.

Up until this point, there has been no possible way of conducting a proper audit or examination of the child welfare industry for the following, very simple reasons:

(1) Any matter dealing with a child is protected, or rather excluded and exempted, under Freedom of Information Act statutes. These matters extend from the actual child's identity to the administrative and fiscal operations of a child welfare agency.

BIOCLAIM™ SOLUTION: Each child is assigned an unique coded identifier as is each individual rendering service. Data can be aggregated in time intervals, geographically stratified, just to name a few quantitative methods, to examine the internal operations of a child welfare agency.

(2) Non-profits, 501(c)3's or "That which operates in the name of God" for example, even though they are regulated by the state through licensing, are not audited and are not subject to full disclosure in reporting on 990s nor are these organizations obligated to generate annual reports. In short, there is no Continuous Quality Improvement (CQI) nor is there universal language or policy in operations.

BIOCLAIM™ SOLUTION: The reports could be automatically generate from data, automatically providing transparency, better allowing accountability.

(3) The privatization of child welfare has given birth to the infectious growth called Medicaid fraud. These are Quasi-Governmental-Organizaions (QGOs). Privatization has made it virtually impossible for states to contractually debar, sanction, or revoke licensing due to the inherent conflict of interest of executing the policy of the state. QGOs operate within the woven layers of immunity. This means it is difficult for the state to prosecute itself and this is why the States Medicaid Fraud Control Units do not go after, or even attempt to go after, Medicaid fraud in Child Welfare.

BIOCLAIM™ SOLUTION: Constructing and running specialized reports for States Attorney General to aggressively go after Medicaid fraud in Child Welfare would increase States Federal Funding Percentages, the recoveries could become beneficial to General Funds, and removes the inherent conflict of interest.

(4) Medicaid fraud is so perniciously pervasive that States, and Federal entities, lack the resources and sophistication to stop Medicaid fraud, let alone Medicaid fraud in child welfare.


BIOCLAIM™ SOLUTION: Fraud deterrence would pay for itself through an increase in effective and efficient services. Consumers, or to be more specific, children and guardians will have, for the first time in the history of the child welfare system, an opportunity to file a grievance and have it investigated.

BIOCLAIM™ may be be viewed as an empowering democratic tool as it allows the public, and the consumers of child welfare, to be watchdogs with a voice, furthering the end of Medicaid fraud in child welfare.

My fascination with the idea of biometrics being applied to aberrant billing in child welfare will lead me to investigate this cutting-edge technology as it is symbiotic with my work in AI, which I may present in my next post.