West Virginia Woman Charged with TennCare Fraud

Tuesday, June 23, 2020 | 12:47pm
Tabitha Lambert

NASHVILLE, Tenn. – A woman in West Virginia is charged with TennCare fraud for allegedly claiming to live in Tennessee in order to obtain TennCare healthcare insurance benefits.  

The Office of Inspector General (OIG). in a joint effort with the Bristol (TN) Police Department and the Bluefield (VA) Police Department today announced the arrest of 40-year old Tabitha Lambert, currently of Princeton, West Virginia. She is charged with fraud and theft of services of at least $2,500 but less than $10,000.   

Investigators say Lambert falsely reported a Tennessee residence in order to gain enrollment in TennCare for herself and her daughter while she was residing in Bluefield, Virginia. As a result, TennCare paid close to $4,800 in fees and claims on behalf of Lambert and her daughter.

“The OIG would like to recognize the joint efforts of both the Bristol, Tennessee and Bluefield, Virginia police departments,” Inspector General Kim Harmon said. “The OIG hopes to continue these strong established relationships with local authorities in order to continue to protect the citizens of Tennessee and our TennCare resources.”

The charges against her are both class D felonies. If convicted Lambert could face up to 24 years in prison. The case is being prosecuted by District Attorney General Barry Staubus of Sullivan County.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated over 5,760 criminal cases leading to more than $10.8 million ordered in restitution to TennCare.  This has helped lead to a total estimated cost avoidance of more than $163.6 million for TennCare, according to the latest figures. To date, 3,162 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.”