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Three People in Middle TN Must Repay TennCare More Than $21,000

Settlements in TennCare Fraud Cases
Friday, November 09, 2018 | 08:01am

NASHVILLE, Tenn. – Residents of Giles, Maury and Williamson Counties are ordered to repay the state in TennCare fraud cases brought by the Office of Inspector General (OIG).

In Giles County, Kimberly Toone, 36, of Goodspring, must pay restitution in the amount of $3,354.97 and was ordered to serve four years in community corrections probation. She was charged with falsely claiming her minor child lived with her, which qualified her for TennCare. She pleaded guilty to TennCare fraud and theft of services. District Attorney General Brent Cooper prosecuted the case.

Victoria Hippo, 33, of Madisonville, is ordered in a McMinn County case to repay the state $15,310.12; and, she received five years of probation. She was charged with concealment of material facts regarding her household composition. Authorities say she fraudulently reported to the state that her child lived with her as a dependent, when the state learned the child was given up for adoption at birth. She pleaded guilty to TennCare fraud and theft of services. District Attorney General Stephen Crump prosecuted the case.

Ashley M. Craig, 32, of Columbia, is ordered to repay the state $3,147.61, and received two misdemeanor probation sentences in Williamson County.  She was charged with TennCare fraud by doctor shopping for the painkiller Oxycodone, using TennCare as payment. She also has two other cases pending at this time. District Attorney General Kim R. Helper prosecuted the case.

“Part of our mission is to help preserve the integrity of the TennCare program,” Inspector Kim Harmon said. “We do so by vigorously prosecuting anyone who uses or attempts to use the program for unlawful purposes.”

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, 3,047 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.”