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Henderson Co. Woman Charged 3rd Time with TennCare Fraud

Monday, August 26, 2019 | 09:54am

NASHVILLE, Tenn. – A Henderson County woman has been charged for the third time with doctor shopping for controlled substances, using TennCare as payment.

The Office of Inspector General (OIG), with the assistance of the Lexington Police Department, today announced the arrest of Julie Rae Smith, 38, of Lexington.  Smith is charged with 18 counts of TennCare fraud in Henderson County. In May of this year, she was charged with one count of TennCare fraud in Decatur County and her first arrest was in November of 2018, when she was charged with six counts of TennCare fraud in Madison County.

All 25 charges of TennCare fraud by doctor shopping stem from an eight-month period in 2017, when authorities say Smith was treated on 54 separate dates by 32 different providers over a three-county area. During this time period, Smith used TennCare benefits to fraudulently obtain prescriptions for the painkillers Hydrocodone, Percocet, Tramadol, Codeine-Phospate, and Tylenol #3.  TennCare paid for the clinical visits and/or the prescriptions.

“Sadly, prescription drug diversion has a detrimental ripple effect on Tennessee communities,” Inspector General Kim Harmon said. “This case seems particularly egregious considering the numbers and substances.  We appreciate the cooperation of our community partners in working to keep Tennessee safe.”

District Attorney General Jody Pickens will be prosecuting the Henderson County charges. 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, 3,119 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/oig/ and follow the prompts that read “Report TennCare Fraud.”