Gibson County Woman Charged with TennCare Fraud

NASHVILLE – A Gibson County woman is charged in Madison County with using her daughter’s TennCare benefits to get dental services.

 

The Office of Inspector General (OIG), with assistance from Humboldt and Madison County officers, today announced the arrest of Carita Laitice Lee, 33, of Humboldt. 

 

She is charged with two counts of TennCare fraud in a Madison County indictment accusing her of using her daughter’s TennCare to access dental services for herself. Except for special circumstances, dental benefits are not available for adults in TennCare.

 

“A TennCare card for one member of a family is not a ticket to benefits for everyone,” Inspector General Deborah Y. Faulkner said. “Children whose families can’t provide healthcare insurance deserve a healthy start, but the full array of benefits is not extended to adults, especially those who aren’t eligible for the program.”

 

Fraudulently obtaining TennCare medical benefits is a Class E felony that carries a maximum penalty of two years in prison per charge. District Attorney General Jerry Woodall will prosecute.

 

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."