Ohio Woman Charged 2nd Time with TennCare Fraud

NASHVILLE, Tenn. – An Ohio woman is charged for the second time with doctor shopping for prescription drugs, using TennCare insurance benefits as payment.

The Office of Inspector General (OIG), with the assistance of the Maury County Sheriff’s Office, announced the arrest of Lori Fiss, 47, of Hamilton County, Ohio.  She is charged in Maury County with going to multiple providers in a short period of time in order to obtain prescriptions for the painkillers Hydrocodone, Oxycodone and Tramadol, using TennCare as payment. Fiss was being held in the Williamson County Jail on unrelated charges and was later transported to the Maury County Jail where she was served.

Fiss was first arrested in December 2017, after being on the run for eight months, when she was returned to Williamson County from Ohio to be charged with TennCare fraud. She was charged with five counts of TennCare doctor shopping, seven counts of prescription drug fraud and two counts of identity theft.  Authorities say she used TennCare to doctor shop for Oxycodone and Hydrocodone.

“Investigating the abuse of TennCare benefits to obtain opioids is one of our many priorities,” Inspector General Kim Harmon said. “We appreciate the collaborative efforts of local law enforcement to combat this problem.”

District Attorney General Brent Cooper 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, 2,975 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.”