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Giles Co. Woman Charged with TennCare Drug Fraud

Tuesday, September 01, 2020 | 12:13pm
Candace Simmons

NASHVILLE, Tenn. – A Giles County woman is charged with TennCare fraud for selling prescription drugs obtained through TennCare healthcare insurance benefits.   

The Office of Inspector General (OIG) along with the Tennessee Bureau of Investigation (TBI) and the Giles County Sheriff’s Office today announced the arrest of 41-year old Candace A. Simmons, of Pulaski. She’s charged with using TennCare to obtain 90 tablets of the painkiller Oxycodone, and then selling a portion of the pills to an informant. TennCare paid for the doctor’s office visit and for filling the prescription at the pharmacy.

“Prescription drugs intended to help should never be diverted for harm,” Inspector General Kim Harmon stated. “We continue to appreciate our partnerships with Giles County Sheriff’s Department and the TBI in this fight to keep our communities safe.”

TennCare fraud is a class D felony. If convicted, Simmons could face penalties of up to 12 years in prison. The case is being prosecuted by District Attorney General Brent A. Cooper of Giles 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 being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures. To date, 3,078 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.”