OFFICE OF CLINICAL LEADERSHIP

Tennessee Interdisciplinary Health Policy Program (TIHPP)

Pharmacy Student Healthcare Policy Fellowship Rotation

• To understand the importance and effectiveness of an interdisciplinary team (PharmD, MD, & Law students) approach in resolving issues in a dynamic health care system.

• To acquire knowledge and skills to understand the basics of a managed care system including the formation, structure, regulation, function, strengths, and weaknesses.

• To acquire knowledge and skills regarding the structure, daily functions, and regulatory activities of various professional boards.

• To understand the legal aspects of public healthcare from both the prosecution and defense perspectives.

• To develop a perspective of the state's regulation of health care and the ability to operate effectively within those regulations.

• To understand health care policy and regulations as they exist interdependently and collaboratively between the various state agencies, i.e. what role each department plays.

• To understand the auditing process utilized when a managed care system is audited for fraud and/or abuse.

• To develop a research project utilizing the information gained from this rotation in connection with research and statistical data available in state data banks and academic education.

• Department of Health, Board of Licensure
• Tennessee Bureau of Investigation
• Juvenile Justice/DCS
• Department of Correction
• Health Related Boards
  The Board of Medical Examiners is responsible for safeguarding the health, safety, and welfare of Tennesseans by insuring all who practice medicine and surgery within the state are qualified. The Board interprets the laws, rules, and regulations to determine the appropriate standards of practice in order to assure the highest degree of professional conduct.
• Department of Correction:
  The Department of Correction is responsible for the health and mental health treatment of prisoners across the State. The Deberry special needs prison handles the mental health treatment of the seriously mentally ill offender. Deberry also houses the sex offender population and the mentally retarded population in the prison system.

• Tennessee Bureau of Investigation
  The TBI has several departments that interface with healthcare. They are as follows:
  
  a. Medicaid/TennCare Fraud Control Unit. The MFCU is federally mandated to investigate provider fraud in the state Medicaid/TennCare program. Examples of TennCare Fraud include; dispensing generic drugs and billing the MCO for expensive brand-name drugs, billling twice for the same medical service, billing for a more expensive service than rendered, billing for medical services not performed, preventing those with serious or chronic illnesses from enrolling in the program, submitting false enrollment information, denying a recipient necessary care to save money and abuse or neglect of patients. The majority of the MFCU's fraud cases are sent and prosecuted federally.

  b. Drug Investigation Unit. The mission of the narcotics investigation division is to investigate, gather evidence and assist in the prosecution of criminal offenses involving controlled substances, narcotics and other drugs. The unit investigates drug trafficking cases including marijuana-related charges, cocaine, LSD, steroids and prescription drugs.

• Juvenile Justice/DCS
  The Juvenile Justice system works with children who are involved in the court system. They work closely with court advocates who are involved in assisting children who have been abused, neglected, or dependent and other children who are placed out of the home. These advocates work with the court and other agencies to ensure that children receive necessary healthcare services and appropriate resources.