Jefferson Co. Woman Ordered to Repay State in TennCare Fraud Case

NASHVILLE, Tenn. – A Jefferson County woman is ordered to repay the state more than $55,000 after she was charged with TennCare fraud and theft of services.

The Office of Inspector General (OIG) today announced that Consuelo Morales, 44, was sentenced in Jefferson County, where she was accused of enrolling herself and her children in TennCare by falsely reporting her income and rental houses. Factoring in those items would have made her ineligible for TennCare.

Morales must repay the state a total of $55,244.61 for benefits she and her family received while they were on the program. Morales was arrested in January of this year when she was charged by the OIG with TennCare fraud and theft of services over $10,000. The case was prosecuted by District Attorney General James Dunn.

“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.”

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.

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.”