Two People Convicted Of TennCare Fraud - Both Must Repay State For Services

NASHVILLE, Tenn. – Women in Dickson and Maury Counties have been ordered to repay the state for healthcare services paid for by the TennCare program. The Office of Inspector General (OIG) charged both women last year with fraudulently obtaining TennCare benefits.

“We hope those who are abusing the TennCare program are getting the message that we are aggressively pursuing TennCare fraud and making arrests statewide,” Inspector General Manny Tyndall said.  “We have uncovered various schemes that people are using to defraud the TennCare program, but bringing these folks to justice sends a message that we are going to prosecute every case.”

41-year old Nancy A. Daniel of Dickson pleaded guilty to TennCare fraud and theft of services, and must repay the state $47,648.87 in restitution. She was arrested in December of 2014 when she was charged with TennCare fraud and theft of services over $10,000In a plea agreement, she was sentenced to six years in prison, suspended to six years in community corrections.  In addition, the court ordered Daniel not to participate in TennCare as provided by statute.  District Attorney General Ray Crouch, Jr., prosecuted the case.

In Maury County, Susan Morton Cox, 42, of Columbia is ordered to repay the state $32,148.04 for benefits paid on her behalf through TennCare. She was arrested in July 2014, when she was charged with falsely reporting her income, child care and the fact she had family medical insurance in order to obtain TennCare benefits she was not actually eligible to receive.  District Attorney General Brent Cooper prosecuted the case.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3 million being repaid to TennCare, with a total estimated cost avoidance of over $163.6 million for TennCare, according to latest figures. To date, over 2,300 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 log on to Office of Inspector General and follow the prompts that read "Report TennCare Fraud."