Two People in Middle Tennessee Charged with TennCare Fraud

Thursday, September 07, 2017 | 2:40pm

NASHVILLE, Tenn. – Residents of Davidson and Williamson Counties are charged with TennCare fraud in separate cases. One of the cases involves the sale of prescription drugs paid for by the state’s healthcare insurance program; and, the other involves a person making false claims to appear eligible for the program.

The Office of Inspector General (OIG) today announced the arrest of Amanda L. Carter, 38, of Nashville and Glenda Mae Waller, 62, of Franklin.

A Davidson County indictment accuses Amanda L. Carter of obtaining TennCare by claiming a minor child lived with her; without a dependent, she would not have been eligible for TennCare.  In addition, she has been charged with perjury for making false statements to the state in order to obtain TennCare. She is charged with TennCare fraud, theft of services over $10,000 and perjury.   District Attorney General Glenn R. Funk will be prosecuting this case.

In Williamson County, a grand jury charged Glenda Mae Waller with TennCare fraud for allegedly using her TennCare benefits to obtain the painkiller Hydrocodone and later selling a portion of the prescription. District Attorney General Kim R. Helper will be prosecuting this case.

“We strongly believe in the mission of the TennCare program and we are committed to protecting its integrity with direct strikes on all fraud and abuse in the program,” Inspector General Manny Tyndall said. “Preserving the integrity of TennCare – and the benefits it provides to Tennesseans – is priceless.”

TennCare fraud is a Class D felony punishable by up to four years in prison. Theft of services over $10,000 is a Class C felony punishable by up to six 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, 2,897 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.”