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Madison Co. Woman Convicted of TennCare Fraud, Must Repay the State

Monday, October 08, 2018 | 12:37pm
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NASHVILLE, Tenn. – A Madison County woman charged with TennCare fraud must repay the state for benefits received through the state’s healthcare insurance program.

The Office of Inspector General (OIG) today announced that 39-year old Kristie Bailey of Jackson was ordered to make restitution to TennCare in the amount of $17,065.00 and was sentenced to four years judicial diversion probation in exchange for her guilty plea.  

Bailey was indicted in June of this year in connection with failing to report that her husband, who was employed, was a member of her household. As a result, she obtained TennCare healthcare and prescription drug benefits she was not entitled to receive. She was charged with TennCare fraud and theft of services.

“Our mission is to preserve the integrity of the TennCare program, “Inspector General Kim Harmon said. “We do so by diligently investigating anyone who uses or attempts to use the program for unlawful purposes.”

TennCare fraud is now a Class D felony punishable by up to four years in prison. District Attorney General Jody Pickens prosecuted the case.  

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, 3,035 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 log on to www.tn.gov/tnoig/ and follow the prompts that read “Report TennCare Fraud.”