Kentucky Woman Charged with TennCare Fraud

NASHVILLE, Tenn. – A woman living in Horse Cave, Kentucky is charged with TennCare fraud for allegedly reporting a Tennessee residence in order to obtain TennCare healthcare insurance benefits.

The Office of Inspector General (OIG), in a joint effort with sheriff’s offices in Sumner County, Tennesseev and in Hart County, Kentucky today announced the arrest of 44-year old Jamie Lee. She is charged with TennCare fraud and theft of services.  An indictment accuses her of falsely reporting a Tennessee residence while living in Horse Cave, Kentucky in order to maintain TennCare benefits. As a result, TennCare paid nearly $17,000 in fees and claims on her behalf.  

“The OIG would like to recognize the joint effort of both the Sumner County Sheriff’s Department and the Hart County, Kentucky Sheriff’s Office,” Inspector General Kim Harmon said.  “We hope to continue these strong established relationships to ensure that those who choose to abuse TennCare will be brought to justice.”

TennCare fraud is a class D felony and the theft of service charge is a class C felony. If convicted, Lee could face a maximum of 27 years in prison. The case is being prosecuted by District Attorney General Ray Whitley of Sumner 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, 3,086 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.”