US health regulators ask for new ways to define fraud and safe behavior

The US Health and Human Services Department is asking the public for ideas on what should count as healthcare fraud, and what should be considered safe business practices. This means the rules that decide who gets investigated and who gets a pass could change significantly.

The federal anti-kickback statute makes it illegal to pay for referrals in healthcare, but 'safe harbor' rules carve out exceptions. These exceptions define how healthcare companies can legally operate, influencing everything from how hospitals buy supplies to how doctors refer patients. Changing these definitions can shift billions of dollars in legal risk and business opportunities across the entire healthcare system.