2 ms·

The idea of government injury is often invisible. Here is a specific example, and likely 3 of the 6 examples I listed have above are similar factually (anti-ki

The idea of government injury is often invisible. Here is a specific example, and likely 3 of the 6 examples I listed have above are similar factually (anti-kickback): 1. Russians began opening pharmacies in Russian neighborhoods throughout the UD (yes, Russian neighborhoods are a thing); 2. The pharmacies would deliver drugs to the medicare patients and in those deliveries included certain gifts anything from Russian newspapers, magazines, to sometimes Russian caviar; 3. As they do CVS identified the success and bought the network of pharmacies; 4. After the sale a lawsuit was brought, because a pharmacist at just one of these pharmacies mentioned that these additions to the drug deliveries violated anti-kickback laws and as a result the pharmacy took retaliatory action (I believe day shift to night shift and reduced hours) The US government would never have known if it weren't for the pharmacist, and it's the exact behavior prohibited by the Anti-kickback Statute, but I'd challenge you to articulate the injury to the government (in fairness I know you could, but I think you see the strong counter arguments).

mirimir 9y ago
Sure. But the intention is to protect the Medicare and Medicaid programs. And hey, IANAL.
- will_brown 9y ago
  Of course the intent of these laws are to protect Medicare, but you didn't articulate how Medicare was harmed in my real life example. Whether or not the Pharmacy put extra gifts in with the Rx delivery Medicare was not effected. Moreover, the gift has no bearing on Medicare, patients, physicians or reimbursements. To highlight the distinction, say a Dr. prescribed a drug to be filled at the pharmacy, and the patient never actually got it filled, but the pharmacy filed the claim for the Rx with Medicare anyway to get paid for the drug as if the patient had gotten it filled, the harm to the Government is obvious, they just paid a claim for a drug that was never actually dispensed. In fact, when that actually happens, the pharmacy usually double dips, and rips the label off the unfilled drug, sells it to another patient and still gets paid on the claim as if the original Medicare patient picked it up. Anyway sometimes the harm is obvious and sometimes its invisible, but it all illegal.
  - mirimir 9y ago
    Thanks for the clarification.

mirimir 9y ago

Sure. But the intention is to protect the Medicare and Medicaid programs. And hey, IANAL.

will_brown 9y ago
Of course the intent of these laws are to protect Medicare, but you didn't articulate how Medicare was harmed in my real life example. Whether or not the Pharmacy put extra gifts in with the Rx delivery Medicare was not effected. Moreover, the gift has no bearing on Medicare, patients, physicians or reimbursements. To highlight the distinction, say a Dr. prescribed a drug to be filled at the pharmacy, and the patient never actually got it filled, but the pharmacy filed the claim for the Rx with Medicare anyway to get paid for the drug as if the patient had gotten it filled, the harm to the Government is obvious, they just paid a claim for a drug that was never actually dispensed. In fact, when that actually happens, the pharmacy usually double dips, and rips the label off the unfilled drug, sells it to another patient and still gets paid on the claim as if the original Medicare patient picked it up. Anyway sometimes the harm is obvious and sometimes its invisible, but it all illegal.
- mirimir 9y ago
  Thanks for the clarification.