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Residents of Bedford, Lawrence Counties Charged with TennCare Drug Fraud

Thursday, June 14, 2018 | 03:35pm

NASHVILLE, Tenn. – Residents of Bedford and Lawrence Counties are charged using TennCare benefits to doctor shop for drugs – and both have faced the charge multiple times in the past. Doctor shopping involves going to multiple doctors in a short period of time to obtain prescription drugs, using TennCare healthcare insurance benefits as payment.

The Office of Inspector General (OIG), with the assistance of the Lincoln County and Maury County Sheriff’s Offices, today announced the arrests.

Samuel L. Harris, Jr., 43, of Shelbyville, is charged for the fourth time in Lincoln County with obtaining a controlled substance by doctor shopping and obtaining a controlled substance by fraud. Harris’ first three arrests were all between February and August 2015, in Bedford, Rutherford and Coffee Counties. In those cases, which were investigated at the same time, he was charged with doctor shopping for the painkillers Hydrocodone and Oxycodone using TennCare as payment. In plea agreements, he served a total of 22 months in state prison and two years’ probation. District Attorney General Robert Carter will prosecute the Lincoln County case.

Crystal M. Clifton, 36, of Loretto, is charged for the second time with TennCare fraud. A Lawrence County indictment accuses her of three counts of TennCare fraud by doctor shopping. She was first arrested last month when she was charged in Maury County with two counts of TennCare fraud by doctor shopping. District Attorney General Brent Cooper will prosecute the Lawrence County case.

“Using TennCare to obtain prescription drugs illegally will not be tolerated,” Inspector General Kim Harmon said.  We appreciate the collaborative efforts of the local law enforcement agencies and healthcare providers across the state working together to fight the opioid epidemic in Tennessee.”

 TennCare fraud is a Class D felony punishable by up to four years in prison per charge.

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, 2,993 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.”