Georgia Woman Charged with TennCare Fraud, Identity Theft and Forgery

NASHVILLE – A woman from Chickamauga, Georgia, is charged across the state line in Chattanooga with claiming to live in Tennessee in order to get benefits through TennCare, the state’s public healthcare insurance program.

The Office of Inspector General (OIG) today announced the arrest of Alpha Clark, alias Alpha Dee Fossett, 64.  An indictment accuses her of falsifying her TennCare application and reverification documents by saying she lived in Tennessee, even though she had moved to Georgia. The charges cover a period from October 1, 2009 through February 9, 2011.   

Clark is charged with four counts of TennCare fraud, three counts of identity theft and three counts of obtaining a controlled substance by fraud.  In addition to the charges related to residency, she is accused of presenting three prescriptions for the painkillers Roxicodone, Oxycodone, and Percocet that were written under the name and DEA number of a physician without authorization.

In September 2009, Clark was convicted in Georgia of distribution of the painkiller Oxycodone.  She was on probation for that conviction during the time she is alleged to have committed the offenses in Tennessee.

“We intend to prosecute anyone, regardless of where they live, if they lie to get enrolled in TennCare,” Inspector General Deborah Faulkner said. “People who cross the state line to gain a benefit available to Tennesseans aren’t just stealing – they’re hurting the TennCare program.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. Attempting to obtain a controlled substance by fraud and identity theft both are Class D felonies carrying a sentence of up to four years in prison per charge. District Attorney General William H. Cox, III is prosecuting.

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, nearly 1,500 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."