Three Middle Tennessee Residents Charged with TennCare Fraud

Tuesday, March 28, 2017 | 10:39am

NASHVILLE, Tenn. – Three people in middle Tennessee are charged with TennCare fraud. The Office of Inspector General (OIG) today announced that a couple from Davidson County and a woman in Montgomery County are the latest arrests.

The Davidson County arrests, assisted by Metro Nashville police, involve a couple accused of passing forged prescriptions and using TennCare healthcare insurance benefits as payment. Heidi Gotto, 37, and Thomas Rediker, 53, both of Nashville, are charged in an indictment accusing them of three counts of obtaining a controlled substance by fraud and one count of conspiracy to commit TennCare fraud. In addition, Heidi was charged with eight counts of TennCare fraud and three counts of forgery. The drugs involved were the painkillers Morphine and Hydrocodone along with the anti-anxiety medication Diazepam. District Attorney General Glenn R. Funk is prosecuting.

In an unrelated case, Jennifer Lee Mason is charged in Montgomery County with two counts of TennCare fraud involving doctor shopping for the painkiller Hydrocodone. The Montgomery County Sheriff’s Office assisted in the arrest. District Attorney General John W. Carney is prosecuting.

“The fraudulent misuse of TennCare pharmacy benefits is a serious problem in local communities across Tennessee,” Inspector General Manny Tyndall said. “We are working closely with local law enforcement agencies and pharmacies to investigate and prosecute these types of crimes.”

TennCare fraud is now a Class D felony punishable by up to four years in prison.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to more than $3 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures. To date, 2,811 people have been charged with TennCare fraud.

Through the OIG Cash for Tips Program established by the Legislature, Tennesseans can get cash rewards for TennCare fraud tips that lead to convictions. Anyone can report suspected TennCare fraud by calling 1-800-433-3982 toll-free from anywhere in Tennessee, or visit the website and follow the prompts that read “Report TennCare Fraud.”