Two People in Madison County Charged with TennCare Fraud
NASHVILLE, Tenn. – Two people in Madison County are charged with TennCare fraud in related cases. The arrests involve a person allegedly accessing the benefits of a member of TennCare CHOICES, a program that offers nursing facility services and home and community-based services for seniors and for adults with a physical disability.
Anderson is charged with one count of TennCare fraud and two counts of obtaining drugs by fraud. Jackson is charged with one count of TennCare fraud and one count of obtaining drugs by fraud.
Authorities say Anderson used the identity of a TennCare CHOICES recipient in order to receive dental benefits and prescription drugs he was not entitled to receive. Investigators allege that Jackson knowingly aided and abetted his use of the identity of the TennCare CHOICES member.
If convicted, Anderson could face penalties of up to a maximum of 36 years in prison for the charges, which are both class D felonies. Jackson could face up to a maximum of 24 years in prison for the charges.
“The TennCare program is designed to provide benefits for individuals that need the services and medications provided through the proper and legal avenues,” Inspector Kim Harmon said. “The OIG would like to recognize the joint effort of the Jackson Police Department and stress the importance of thwarting individuals from abusing the TennCare program. We hope to continue these strong established relationships with local authorities in order to continue to protect the citizens of Tennessee and taxpayer money.”
In both cases, District Attorney General Jody Pickens is prosecuting.
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, 3,138 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.”