Residents of Monroe, Knox Counties Charged with TennCare Fraud

Wednesday, August 23, 2017 | 11:28am

NASHVILLE, Tenn. – Residents of Monroe and Knox counties are charged with TennCare fraud in separate cases out of Knoxville.

The Office of Inspector General (OIG) today announced the arrest of Teresa A. Davis, 47, of Knoxville and Earnest Breeden, 63, of Loudon.

Davis is charged with TennCare fraud and theft of services in connection with failing to disclose her correct income to the state in order to appear eligible for TennCare healthcare insurance benefits.

Breeden is charged with TennCare fraud, obtaining a controlled substance by fraud and attempt to obtain a controlled substance by fraud. Authorities say that on two separate occasions, Breeden altered legitimate prescriptions to increase the strength of the drug, attempting to use TennCare to pay for the altered prescriptions. Pharmacy staff caught the second forgery and alerted authorities.

“It doesn’t matter if you’re cheating to get taxpayer-funded healthcare benefits or using TennCare to get prescription drugs you’ve not been prescribed, we’re going to find out and pursue charges,” Inspector General Manny Tyndall said. “The OIG was the solution to a problem when it was formed over a decade ago, and we continue to develop new tools for fighting TennCare fraud.”

District Attorney General Charme P. Allen 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, 2,889 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.”