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 Pharm

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.