Roane Co. Man Charged with TennCare Fraud

NASHVILLE, Tenn. – A Roane County man is charged with TennCare fraud for “hiding” a family member’s assets in order to make the person appear eligible for benefits that would pay for nursing home care.

The Office of Inspector General (OIG), with assistance from Roane County Sheriff’s deputies and Knoxville police, today announced the arrest of James Thomas Reed, 62, of Harriman.

Reed is named in a two-count indictment charging that he concealed assets so taxpayers would pay for nursing home care for his mother by failing to report his mother’s retirement fund income and falsifying bank statements from a credit union. As a result, his mother received TennCare benefits and assisted living benefits totaling $63,091.84. Reed was charged with TennCare fraud and theft of services over $60,000.

“TennCare provides specialized care for low-income people who are truly eligible, need assistance and do not have any assets,” Inspector General Manny Tyndall said. “Many people want to preserve their assets for children or other beneficiaries, but federal law prohibits what is known as “pauperizing” a person so the state and federal government pay for expensive long-term care.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison.  Theft of services over $60,000 is a Class B felony punishable by up to twelve years in prison.  District Attorney General Russell Johnson is prosecuting.

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, 2,621 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 log on to www.tn.gov/tnoig/ and follow the prompts that read “Report TennCare Fraud.”