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Enforcement Mechanisms

Learn about the interrelationship between the three main fraud-and-abuse laws, public enforcement, private enforcement generally, and self-reporting programs.


Three primary federal laws used to combat healthcare fraud and abuse are the False Claims Act, the Anti-Kickback Statute, and the Stark Law. The False Claims Act prohibits false claims to the government for money, such as false claims for Medicare reimbursement. The Anti-Kickback Statute and the Stark Law both prohibit kickbacks for referring Medicare patients for treatment. However, the Anti-Kickback Statute is criminal and has a broader reach, and the Stark Law is civil and has a narrower...