Two People in Hawkins County Charged with TennCare Fraud

NASHVILLE – Two people in Hawkins County have been charged with TennCare fraud for using TennCare benefits to pay for fraudulent prescriptions.

The Office of Inspector General (OIG) along with the Rogersville Police Department and the Hawkins County Sheriff’s office today announced the arrest of Edgar Billy Chess, Jr., 38, and Brenda S. Seal, 44, both from Rogersville.

Chess is accused of presenting altered prescriptions for the painkiller oxycodone on three separate occasions, and using TennCare to pay for the prescriptions.

Seal was indicted on one count of TennCare fraud and one count of identity theft, and accused of knowingly using the personal identifying information of a health care provider by altering a prescription in order to obtain the painkiller hydrocodone, which she intended to pay for with TennCare.

“Providers, local law enforcement officials and state agencies are simply no longer tolerating abuse of TennCare, especially when it relates to addictive prescription painkillers,” Inspector General Deborah Y. Faulkner said. “We’re intent on prosecuting every one of these cases to the fullest extent possible.”

If convicted, both could spend one to two years in prison. District Attorney C. Berkeley Bell will prosecute.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $2.6 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $165 million for the TennCare program, according to latest figures.  To date, over 920 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 from anywhere in Tennessee, or log on to www.tncarefraud.tennessee.gov and follow the prompts that read "Report TennCare Fraud."