Elon, want to cut billions in healthcare fraud? Use plastic!
A "kid" I grew up with has come up with a way to use secure smart cards -- think VISA cards & bank debit cards -- to prevent billions in annual healthcare fraud & waste.
A Letter to Elon, Robert & Vivek —
Dear Robert F. Kennedy Jr, Elon Musk, Vivek Ramaswamy --
The second Trump administration is promising to slash the federal budget and eliminate waste and fraud. It's long overdue and something I've been working to solve as a private citizen for two decades.
One of the first places your people will search for fraud and waste in Washington will be health care, where fraud is rampant and estimated by the GAO to cost an estimated $233 billion to $521 billion annually. The GAO also says “Significant Improvements Are Needed to Address Improper Payments and Fraud.”
I'm the CEO of Castlestone Advisors, a company I formed to use the latest smart-card technology to stop or reduce fraud, waste and inefficiency in government healthcare systems.
I've proved that by using secure, plastic smart cards -- like VISA cards and bank debit cards -- healthcare fraud can be slashed significantly and quickly in a cost-effective way.
(The current fraud rate in healthcare is about 10% while the fraud rate in credit cards is 0.1% -- which is why a stolen Visa credit card number is worth $25 and a stolen health identity is worth $1,000.)
Thousands of false catheter orders, fake back brace orders, fake genetic tests, fake dental operations, etc. -- they add up to tens of billions of dollars in fraud each year. Meanwhile healthcare systems can't fight fraud or keep track of their customers because so many health identities are stolen or invented.
None of this is new for me. My efforts to help federal and state governments fight fraud were mentioned favorably in this 2017 Inc. magazine article.
Castlestone's technology revolves around getting a program provider, such as Medicare or, say, your healthcare insurance provider, to issue an ID card to users. This card would be configured to work in the point of sale (POS) terminals found anywhere plastic is accepted. It is not a credit card but transmits data in real-time.
Castlestone is permitted to tap into basic time, location and transaction pattern data that is standard every time a card is read. Castlestone factors in other details it collects about the facility and the patient.
The result is an instantly calculated risk score that can be used to approve, reject, or suspend payment. This transaction record is also compared with the claim. By verifying that the patient was in the doctor’s office, this can eliminate the use of stolen identities to file claims.
At the state level, Medicaid fraud is as large, if not a larger problem.
In 2014, my company Castlestone was part of a winning bid to replace the Medicaid system in New York that would have prevented, detected, or deterred $2 billion of fraud annually. Unfortunately, Governor Andrew Cuomo canceled our portion of the contract. We had similar experiences in Sacramento.
With Trump's victory and the crusade to cut trillions out of the federal budget, it is time to address and stamp out healthcare fraud. I have the knowhow and tools to help make that happen and I want to help.
Thank you very much. I’m available at any time to speak with you or your staff.
Jeff Leston
jeff@castlestone-llc.com
www.castlestone-llc.com
