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Reigning in Fraud, Waste and Abuse in Government Spending

Reigning in Fraud, Waste and Abuse in Government Spending

May 15, 2015 0 Comments

Just-released news from the Washington Post about the Department of Veterans Affairs violating federal contracting rules to pay for medical care and supplies was only the latest acknowledgement of fraud, waste and abuse in government. Why is this occurring, and what can we do to stop it?

In this case, and many others like it, the purchasing rules are documented but not followed. Why? Surely there are some cases of fraud—purchasers knowingly violating the rules. I suspect—some might say naively—that this is a small part of the problem. But it’s more likely that the rules are too complex or tedious to follow, as the Post article suggests.

Automating Enforcement of Rules Reduces Fraud, Waste and Abuse

Fortunately, there is a solution that addresses both problems: automate the enforcement rules using a Business Rules Management System (BRMS). A BRMS can be bolted onto purchasing systems and enforce business rules across every purchase transaction. Simply put, a purchase will not go through that does not adhere to the rules.

Why is this not happening today? Most organizations attempt to automate their business rules by programming them into the application code of their systems. But this approach takes far too long to implement and modify business rules. In the case of purchasing rules, where there are hundreds of thousands of items to purchase, with both pricing and new items updated daily, it’s not possible to keep up with the rate of change. Changes to code take weeks or months using traditional programming techniques.

But rapid change is where a BRMS shines. Changes to rules in a BRMS take minutes or hours to implement, and can be made by subject matter experts without requiring changes to code. Only this way can we keep up with the pace of changing rules.

BRMS are being adopted at an increasing pace by government. In order to comply with the Affordable Care Act, most states have adopted a BRMS as a part of their benefits eligibility and health insurance exchange systems. In an honorable display of wisdom, the Center for Medicaid and Medicare (CMS) actually required the use of a BRMS, in order to gain access to enhanced federal funding to support these new systems. Let’s apply this lesson to other areas of government, and reign in fraud, waste and abuse.

Dr. Mark Allen

Dr. Mark Allen

Dr. Mark Allen is a Progress General Manager, dedicated to advancing business automation and passionate about applying technology to improve the world. In 2000, he founded Corticon, later acquired by Progress in 2011. Under his leadership, Corticon became a leading independent business rules platform with hundreds of customers in diverse industries such as financial services, government, healthcare and insurance. Prior to founding Corticon, Dr. Allen developed rules-based systems to help physicians make better patient care decisions. Dr. Allen has a B.S. in Applied Physics from Columbia University, and an M.D. from the University of California Los Angeles.

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