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Marshall Co. Woman Charged with TennCare Fraud

Thursday, October 31, 2019 | 10:48am
MCulwell

NASHVILLE, Tenn. – A Lewisburg woman is charged with TennCare fraud for allegedly selling pills which were obtained using benefits of TennCare, the state’s healthcare insurance program.

The Office of Inspector General (OIG) today announced the arrest of Melissa Culwell of Marshall County, Tennessee. The arrest is the result of a joint effort with the Smithville Police Department, the DeKalb County Sheriff’s Department, and the Marshall County Sheriff’s Department. Culwell is charged with one count of knowingly selling drugs she obtained through the use of her boyfriend’s TennCare benefits.   The case is being prosecuted by District Attorney Robert J. Carter of Marshall County, TN.

“Part of the mission of the Office of Inspector General is to prevent people from using their TennCare benefits to sell drugs on the streets of Tennessee communities,” Inspector General Kim Harmon said.  “We strive to ensure that taxpayer money is being used properly and that people are held accountable for their actions.”

Investigators say Culwell signed for and picked up a prescription for 120 tablets of the painkiller Percocet which had been prescribed for her boyfriend. Agents say Culwell knew the pills were provided through her boyfriend’s Medicare and Medicaid benefits. Culwell subsequently admitted to selling the drugs on the street and keeping the profits for herself.  

TennCare Fraud is a Class D felony.  If convicted, Culwell could face penalties of up to a maximum of 12 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, 3,123 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 or by logging on to www.tn.gov/oig/ and following the prompts that read “Report TennCare Fraud.”