Two Sumner County Residents Charged with TennCare Fraud

NASHVILLE – Two people from Sumner County – a male and female - have been charged with TennCare fraud involving prescription painkillers. 

The Office of Inspector General (OIG) and the Sumner County Sheriff’s Office today announced the arrest of Mark Stafford, 38, and Ashley N. Menke, 23, both of Hendersonville.

Stafford is charged with four counts of fraudulently obtaining controlled substances by “doctor shopping.” He is accused of going to several healthcare providers within a 30-day perioed to obtain prescriptions for the painkillers hydrocodone and a time-release version of morphine, along with the anti-depressant alprazolam.   The clinical visits were paid for by TennCare.

In a separate case, Ashley Menke is charged with two counts of TennCare fraud for using TennCare to fraudulently obtain the prescription painkiller tramadol.

“The fraudulent use of TennCare pharmacy benefits is a serious issue that local communities are committed to ending, and we continue to work with them to investigate and prosecute these cases,” Inspector General Deborah Y. Faulkner said. “We truly appreciate all the support we receive from the medical and law enforcement communities.”

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison.   District Attorney Lawrence R. Whitley will be prosecuting these cases.

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.tn.gov/tnoig and follow the prompts that read "Report TennCare Fraud."