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North Carolina Man Charged with TennCare Fraud

Wednesday, May 19, 2021 | 05:14pm
Foster

NASHVILLE – A North Carolina man is charged with TennCare fraud for allegedly falsely reporting a Tennessee residence in order to obtain TennCare healthcare insurance benefits.  

The Office of Inspector General (OIG) today announced the arrest of James Foster, 27, of Monroe, North Carolina. He is charged with TennCare fraud, which is a class C felony, and theft of services over $10,000 but under $60,000, a class D felony. Investigators allege that Foster was residing in North Carolina when he falsely reported a Tennessee residence to maintain TennCare benefits, resulting in TennCare paying more than $30,360 in fees and claims on his behalf.  

“The TennCare program is designed to help those who rightfully qualify for benefits,” Inspector General Kim Harmon said.  “OIG strives to ensure that those taking wrongful advantage of Tennessee’s Medicaid program will be brought to justice.”

The case is being prosecuted by District Attorney General Mike Flynn of Blount County.

The OIG, which is separate from TennCare, began full operation in February of 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. TennCare’s budget is comprised of both federal and state dollars: 65% and 35% respectfully. To date, 3,116 people have been charged with TennCare fraud.

The OIG’s most wanted for TennCare fraud are posted online at https://www.tn.gov/finance/fa-oig/fa-oig-most-wanted.html. Anyone with information about their whereabouts is urged to use the contact information on the page.  

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.”