Wilson Co. Woman Charged with TennCare Fraud

Monday, May 01, 2017 | 11:57am

NASHVILLE, Tenn. - A Wilson County woman is charged with TennCare fraud in connection with falsely reporting her monetary assets in order to obtain benefits under a special TennCare program that assists low-income people with Medicare expenses. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities and people with End-Stage Renal Disease.

The Office of Inspector General (OIG), with the assistance of the Wilson County Sheriff’s Office, today announced the arrest of Joan M. Graves, 67, of Mt. Juliet. She is charged with TennCare fraud and theft of services over $10,000 in an indictment that accuses her of failing to report her monetary assets in order to receive TennCare benefits through the Qualified Medicare Beneficiary (QMB) program.  

“This is a common scheme used by people who want to make themselves look poor on paper while the taxpayers are picking up the tab for their medical services,” Inspector General Manny Tyndall said. “We have uncovered various schemes used to defraud the TennCare program, but bringing these folks to justice sends a message that we’re going to prosecute these cases.”

District Attorney General Tom P. Thompson, Jr. is prosecuting. TennCare fraud is now 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, 2,828 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.”