Development and implementation of a managed care rotation in medical necessity review: Exposing students to new opportunities

The purpose of this project was to design a rotation for fourth-year PharmD students in managed care through medical necessity review. There are few r otations currently offered in this area, and with the domination of managed care in our healthcare system it is important to show students its opportu nities and challenges. The rotation involved working with the Tennessee Dep artment of Health's TennCare Appeals Unit. Throughout the development proce ss and implementation, the students were exposed to the various aspects of the appeal process, and to the complexity of managed care. This rotation ex poses students to the impact pharmacists can have on patients' lives within the managed care realm that didactic lectures cannot adequately explain. A s a model for professional development, the experience showed the advantage of utilizing pharmacists as drug therapy experts in an area where physicia ns have dominated the practice, and the potential to expand the pharmacy pr actice environment.