May 01, 2018

The Travel Act: sixty-year old “new” tool in healthcare fraud enforcement

Patrick D. Souter, Gray Reed & McGraw LLP, Dallas, TX

It is undisputed that a major hurdle in being able to provide the financial resources necessary to deliver quality healthcare in the United States is the amount of fraud prevalent in the industry. Fraud committed against both governmental and private payors drains resources better spent on the provision of healthcare rather than lining the pockets of those who take advantage of these payors. Federal enforcement has traditionally been through prosecutions utilizing the Federal Anti-Kickback Statute (AKS),1 the Physician Self-Referral Law, or “Stark Law”,2 and the False Claims Act (FCA),3 as well as administrative actions such as Civil Monetary Penalties4 and exclusion authority to prohibit those committing fraudulent acts from participating in federal programs.5 The federal government utilizes other fraud-related statutes in its prosecutorial efforts such as mail and wire fraud, fraudulent act statutes, and accompanying financial-based statutes such as money laundering to supplement the traditional federal healthcare fraud, waste and abuse laws.

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