Grainger County Woman Charged with TennCare Fraud

NASHVILLE – A Grainger County woman is charged with attempting to use another person’s identity in order to obtain medical services through TennCare, the state’s public healthcare insurance program.

The Office of Inspector General (OIG), with assistance from the Knox County Sheriff, today announced the arrest of Carole Lee Coffey, 31, of Bean Station. 

A Knox County indictment accuses Coffey of using the identification of a TennCare member to get medical services paid for by TennCare.  She’s charged with one count of TennCare fraud and one count of identity theft.  Only the person named on a TennCare enrollment card can use the card for services, because that person has met the TennCare eligibility requirements.

"We won’t allow people who are not eligible for TennCare to get by with using a legitimate enrollee’s benefits to pay for their own services,” Inspector General Deborah Y. Faulkner said. “When we find people doing so, we will prosecute them to the fullest extent of the law.”

District Attorney General Randall E. Nichols will prosecute. If convicted, Coffey could be sentenced up to four years for the identity theft charge which is a Class D felony and two years for the TennCare fraud charge, which is a Class E felony.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $173 million for the TennCare program, according to latest figures.  To date, over 1,400 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."