Davidson Co. Woman Must Repay TennCare in Fraud Plea Deal

Thursday, April 04, 2019 | 03:50pm

NASHVILLE, Tenn. –– A Davidson County woman is ordered to repay the state after she entered a plea agreement on charges involving TennCare fraud.

The Office of Inspector General (OIG) today announced that 38-year old Heather Ann Pitts of Nashville pleaded guilty to charges stemming from allegedly claiming a minor child as a dependent in order to qualify for healthcare insurance benefits through TennCare. Without a child as a dependent, she would not have been eligible for the program. She pleaded guilty to TennCare fraud, theft of services over $10,000 and theft of services over $60,000. In exchange for the plea, Pitts is ordered to pay TennCare $18,000.00 in restitution and she received three consecutive sentences of 11 months and 29 days of supervised probation.

“Providing false information in order to receive TennCare benefits is a crime,” Inspector General Kim Harmon said. “The Office of Inspector General works diligently to preserve the integrity of TennCare benefits, so that those truly deserving of and eligible for TennCare have the best resources,”

TennCare fraud is now a class D felony punishable by up to four years in prison. District Attorney General Glenn R. Funk prosecuted this 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, 3,076 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.”