In the fast-growing world of medical tourism, hospitals and clinics often rely on facilitators and intermediaries to help connect patients with care across borders. These facilitators coordinate logistics, provide support, and, in many cases, even help patients make payments for their procedures.
At first glance, that may seem harmless — or even helpful. But what many healthcare providers don’t realize is that how a facilitator handles patient payments can expose the hospital itself to legal risk, regulatory scrutiny, and serious reputational harm. In some situations, a hospital could even face liability for financial crimes committed by others if it knowingly benefits from or turns a blind eye to them.
This is an issue most in the industry have never truly examined — yet it’s one of the most critical compliance challenges medical tourism faces today. As regulators tighten financial rules worldwide, hospitals and clinics must understand the risks and know how to protect themselves.
Why This Matters More Than Ever
Medical travel is becoming more sophisticated. Patients now expect transparency, trust, and security in every part of their healthcare journey — and that includes how their money is handled.
At the same time, governments around the world are cracking down on unregulated money transfers, cross-border payment risks, and potential avenues for fraud and money laundering. Laws that once applied mainly to banks now extend to anyone handling consumer funds on behalf of someone else.
That means a medical tourism facilitator who collects payment from a patient and then sends it to a hospital overseas is, in most jurisdictions, acting as a money transmitter — a heavily regulated financial activity. If they do this without the proper licenses or safeguards, they could be breaking the law.
And if your hospital knowingly accepts funds sent through that illegal process? You could be pulled into the legal mess too.
How a Facilitator’s Actions Can Put Your Hospital at Risk
Imagine this scenario:
- A patient in the United States pays $10,000 to a medical tourism facilitator for surgery at your clinic in Panama.
- The facilitator deposits the money into their company bank account.
- Later, they transfer the funds to your hospital.
If that facilitator is not a licensed money transmitter in the U.S., they may be violating federal and state law — even if their intention is purely to help. And because your hospital accepted and benefited from funds that were handled illegally, you may be considered part of that transaction chain.
This isn’t just a theoretical risk. Financial regulators, prosecutors, and civil courts have repeatedly shown that an organization does not have to commit the violation itself to face consequences. Simply aiding, abetting, benefiting from, or turning a blind eye to an illegal practice can be enough.
U.S. Law: Ignorance Is Not a Defense
Hospitals that treat U.S. patients — even if located outside the United States — must pay close attention to how funds originating from the U.S. are handled.
Under U.S. federal law, anyone engaged in “money transmission” must be registered with the Financial Crimes Enforcement Network (FinCEN) and comply with strict anti–money laundering (AML) rules. State laws add another layer of licensing requirements.
A facilitator who receives patient funds and then transmits them to a hospital may fall squarely under this definition. And under 18 U.S.C. § 2, anyone who “aids and abets” that violation is subject to the same penalties. That includes foreign entities that knowingly benefit from the activity.
The same principle applies under 18 U.S.C. § 371 (conspiracy). If a hospital and a facilitator agree — even implicitly — to a system that violates financial laws, both could be held liable, regardless of who collected the funds.
Importantly, knowledge of the specific law is not required. It is enough that the hospital knew (or should have known) that the facilitator was receiving and transmitting funds without proper authorization.
Willful Blindness: What Hospitals “Should Have Known”
Hospitals sometimes argue, “We didn’t know the facilitator was unlicensed.” But courts often reject that defense if there were red flags they chose to ignore.
The legal concept of willful blindness means a company cannot escape liability by deliberately avoiding knowledge of wrongdoing. If the circumstances strongly suggest that a facilitator is illegally handling money, and the hospital continues to accept those payments, regulators and courts can treat that as equivalent to actual knowledge.
Some common warning signs include:
- Patient funds consistently arriving from a facilitator’s personal or company account rather than directly from the patient.
- Facilitators marketing themselves as “holding” or “collecting” patient payments.
- Lack of transparency about where the money is coming from.
- Inability or refusal to provide proof of money transmitter registration or licensing.
If your organization sees any of these red flags and does nothing, you are no longer simply an innocent recipient — you could be seen as part of the unlawful process.
Civil Liability: “Knew or Should Have Known”
Even if regulators don’t bring criminal charges, hospitals can still face civil lawsuits if patients lose money or are harmed by how payments were handled.
In U.S. courts and many other jurisdictions, a plaintiff only needs to show that the hospital “knew or should have known” about the improper activity. This lower legal threshold is often enough to support claims such as:
- Civil conspiracy: Alleging that the hospital and facilitator jointly participated in an unlawful scheme.
- Aiding and abetting: Arguing that the hospital enabled or benefited from illegal conduct.
- Negligence or breach of fiduciary duty: Claiming the hospital failed to safeguard patient interests.
These cases can lead to expensive settlements, judgments, and lasting reputational harm — even if the hospital itself never touched the funds until they arrived.
Reputational and Business Risks Are Just as Serious
The legal consequences are only part of the story. Even if a hospital avoids prosecution or lawsuits, its reputation can suffer irreparable damage if patients discover that their money was misused or mishandled.
Media coverage of “lost payments” or “facilitators under investigation” almost always names the provider involved. Insurers, governments, and international partners may reconsider working with a facility linked to questionable payment practices.
Banks may also flag the hospital’s accounts if they suspect incoming payments are part of unlicensed money transmission. That can lead to account freezes, compliance reviews, and disruptions in financial operations — even if the hospital did nothing intentionally wrong.
The “Global Reach” of Liability
It’s not only U.S. law that matters. Similar money transmission and AML regulations exist in Canada, the UK, the EU, and most of Latin America.
For example:
- In Canada, the Proceeds of Crime (Money Laundering) and Terrorist Financing Act requires money services businesses to register with FINTRAC and follow strict reporting and record-keeping rules.
- In the UK, handling or transmitting funds without authorization from the Financial Conduct Authority (FCA) can lead to criminal penalties under the Financial Services and Markets Act and the Money Laundering Regulations 2017.
- In Colombia, Panama, Turkey, and other destination countries, financial regulators closely monitor cross-border transfers and may investigate suspicious inflows, freeze funds, or require proof of compliance.
Hospitals receiving international patients should assume that if the funds originate abroad, they are subject to the financial laws of the sending country — and possibly those of the receiving country too.
How This Affects Facilitators and Hospitals Working Together
Facilitators play a valuable role in medical tourism. They often provide essential services that help patients navigate complex treatment journeys. But when facilitators cross the line into handling money, they step into a heavily regulated space.
Hospitals that partner with facilitators must take this seriously. Even if the facilitator is a trusted partner or has been operating for years without issue, that does not shield the hospital from risk. Financial regulators do not care about intent — they care about compliance.
The safest course of action is for hospitals to establish clear policies around how patient payments are handled, including:
- Requiring that all patient payments are made directly to the hospital or through a licensed, regulated platform.
- Asking facilitators for documentation of any financial licenses they hold.
- Including payment compliance clauses in partnership agreements.
- Conducting periodic reviews of how patient funds are being processed.
By taking these steps, hospitals can significantly reduce the risk of being implicated in illegal or non-compliant payment practices.
What Happens If the Facilitator Disappears or the Money Is Lost?
Another major risk hospitals often overlook is consumer protection. If a facilitator receives patient money and goes bankrupt, commits fraud, or simply disappears, the patient may never recover their funds.
In many jurisdictions, the hospital could face legal claims from the patient, arguing that it was negligent in working with that facilitator or failed to disclose the risks.
Patients are becoming more aware of these issues — and regulators are watching closely. Hospitals that want to build trust and attract international patients must ensure not only that the medical care is world-class, but also that the financial process is secure and compliant.
Why “I Didn’t Know” Isn’t Good Enough Anymore
One of the most dangerous misconceptions in the medical tourism industry is that a hospital cannot be liable if it never directly handled patient funds. That is simply not true.
- Knowledge is not required to face civil lawsuits. If a hospital “should have known,” it may still be liable.
- Willful blindness is treated as knowledge in many jurisdictions. Ignoring obvious red flags is no defense.
- Aiding and abetting laws apply even to those who only indirectly benefit from an illegal activity.
In short, “We didn’t collect the money” is not a shield. If a hospital knowingly allows or benefits from a facilitator’s non-compliant behavior, it can absolutely be held responsible — both legally and financially.
The Path Forward: A Safer, Compliant Model for the Industry
The good news is that these risks are avoidable. The medical tourism industry is evolving, and new payment models are emerging that allow hospitals, facilitators, and patients to operate in a fully compliant, transparent, and secure way.
Platforms like Better by MTA, created in partnership with Mastercard, were designed specifically to solve these problems.
Instead of patients wiring money to a facilitator’s bank account, Better by MTA enables them to pay directly through a licensed, secure payment system. The funds are processed in compliance with applicable financial regulations, and both hospitals and facilitators receive payments through a transparent, legally compliant flow.
This model offers several key benefits:
- Legal compliance: Transactions comply with financial regulations in the patient’s country and the destination country.
- Consumer protection: Patients have peace of mind knowing their money is secure — even if a facilitator or other intermediary is involved.
- Trust and transparency: Hospitals can demonstrate that they operate under best practices, strengthening their reputation with patients, insurers, and partners.
- Facilitator protection: Facilitators can continue providing services without risking prosecution for unlicensed money transmission.
In other words, platforms like Better by MTA allow the industry to retain the value of facilitators while eliminating the legal, financial, and reputational risks associated with outdated payment practices.
Medical tourism is built on trust — trust in the quality of care, trust in the providers, and trust in the process. But trust can quickly unravel if money is mishandled, even if unintentionally.
Hospitals and clinics cannot afford to ignore how their patients’ payments are being collected and transferred. If a facilitator is handling funds illegally, the hospital could face consequences too — even if it never asked them to.
The safest path forward is to eliminate the risk at its source: require compliant payment processes, verify how funds are handled, and embrace platforms that build security into the heart of the medical travel experience.
The future of global healthcare depends not just on delivering excellent care — but on building a system that patients, facilitators, and hospitals can trust. With solutions like Better by MTA and Mastercard, that future is already here.
he safest and smartest way to restore trust and eliminate risk is to modernize how you handle payments. That’s exactly why leading hospitals, clinics, and facilitators around the world are adopting Better by MTA — the only medical tourism payment platform built from the ground up to solve these challenges.
Better by MTA was designed in partnership with Mastercard to bring trust, compliance, and security into every payment. It allows patients to pay with confidence, knowing their money is protected and handled through regulated channels. Hospitals receive funds directly and securely, without exposure to legal or reputational risk. Facilitators can focus on care coordination without stepping into regulated financial territory.
By integrating Better by MTA into your patient payment process, you transform a major source of risk into a powerful advantage. You’ll close more patients because they trust the process. You’ll build stronger partnerships because providers and payers know you’re compliant. And you’ll future-proof your business as regulations tighten around the world.
If your business still relies on outdated payment practices, now is the time to evolve. Visit https://better.medicaltourism.com to learn how Better by MTA can protect your patients, your reputation, and your future.
