Knox Co. Woman Charged 3rd Time with TennCare Fraud

NASHVILLE, Tenn. – A Knox County woman is charged for the third time with doctor shopping for prescriptions, using TennCare state healthcare insurance benefits as payment.

The Office of Inspector General (OIG), with the assistance of the Davidson County Sheriff’s Office, today announced the arrest of Pamela L. Goetsch, 47, of Knoxville. She is charged in Davidson County with using TennCare to visit multiple providers in a short period of time in order to obtain prescriptions for Diazepam, an anti-anxiety medication. TennCare paid for the clinical visits, the prescriptions, or both. Goetsch was being held in the Loudon County Jail on unrelated charges and was later transported to the Davidson County Jail where she was served.

Goetsch was arrested just last month on an indictment in Loudon County when she was charged with doctor shopping for the painkiller Hydrocodone, using TennCare as payment. She was first arrested in August of this year on a Knox County indictment on seven counts of using TennCare to obtain prescriptions for the painkillers Oxycodone and Hydrocodone, using TennCare as payment.

Authorities were investigating these cases concurrently; indictments were handed down separately.

“The abuse of TennCare benefits, especially to obtain pain medications, is one of our many priorities,” Inspector General Manny Tyndall said. “Tennesseans throughout our communities are helping us in the effort to weed this problem out of the TennCare program.”

District Attorney General Glenn R. Funk is prosecuting. As of July 1, 2016, TennCare fraud was changed to 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, 2,743 people have been charged with TennCare fraud.

Anyone can report suspected TennCare fraud by calling 1-800-433-3982 toll-free from anywhere in Tennessee, or visit the website and follow prompts that read “Report TennCare Fraud.”