Part I: Violation of Pharmacist Guideline 

“Most Medicare Prescription Drug Plans have a  coverage  gap (which is also called the “donut hole”). This means there  is a  temporary limit on what the drug plan will cover for drugs.” Click  here to review and analyze additional information on coverage gap.

Now, analyze the following scenario.

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A pharmacist  submits Medicare claims for  brand name medication instead of following the  guidelines to provide  the patients with the less expensive, generic  medicines.

Respond to the  following:

  • Which  law, if any, is violated by the pharmacist? 
  • By  using the Internet, research and provide a similar real-life example. 

Justify your answers  with appropriate  research and reasoning by using examples and references from  textbooks,  the South University Online Library, and other acceptable  references.  Cite sources in the APA format. Further, comment on the postings  of at  least two peers.

Part II: Breach of Contract

A  contract consists of a voluntary  agreement that two parties enter into with  the intent of benefitting  each other (Fremgen, 2012). Something of value,  which is termed  consideration, is part of the agreement (Fremgen, 2012). A  contract can  be either expressed or implied. An express contract is an  agreement  that clearly states all the terms. It can be entered into orally or  in  writing (Fremgen, 2012).

A  breach of contract occurs when either  party fails to comply with the terms of  the agreement (Fremgen, 2012).  For example, if a physician refuses to perform  a medical procedure he  or she had agreed to perform, the physician has  breached the contract  (Fremgen, 2012). If a patient does not pay an  agreed-upon fee, then the  patient breached the contract with the physician  (Fremgen, 2012).

Now,  respond to the following questions:

  • Find out your state’s current court  decisions for  breach of contract and provide an example of breach of contract   affecting a hospital. 
  • Review and describe the state’s methodology  for addressing issues pertaining to such a breach of contract. 
  • Describe how legal procedures have evolved  over time to help reduce such occurrences. 
  • Describe how the breach of contract you  identified could have been avoided. 

Justify your  answers with appropriate  research and reasoning by using examples and  references from textbooks,  the South University Online Library, and other  acceptable references.  Cite sources in the APA format. Further, comment on  the postings of at  least two peers.

Source: 

Fremgen, B.  (2012). Medical law and ethics. (4th  ed.). Boston, MA: Prentice
             Hall

 
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