Knox Co. Woman Charged 2nd Time with TennCare Fraud

NASHVILLE, Tenn. – A Knox County woman is charged for the second time with TennCare fraud involving prescription drugs.

The Office of Inspector General (OIG), with the assistance of the Loudon County Sheriff’s Office, today announced the arrest of Pamela L. Goetsch, 47, of Knoxville. She is charged in a Loudon County indictment with doctor shopping for the painkiller Hydrocodone, using TennCare as payment. Doctor shopping is a crime that involves going to multiple doctors in short period of time to obtain prescription drugs and using TennCare as payment.

Goetsch was first arrested earlier last month in Knox County, when she was charged with seven counts of doctor shopping for both Oxycodone and Hydrocodone, using TennCare benefits as payment.

“We have open cases in almost every county in Tennessee,” Inspector General Manny Tyndall said. “We’re committed to stopping this type of activity so TennCare will be there for people who have legitimate needs for healthcare benefits.”

District Attorney General Russell Johnson 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, 2,728 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.”