Roane County Woman Charged with TennCare "Doctor Shopping"
NASHVILLE – A Roane County woman is charged with “doctor shopping” using TennCare, with the indictment coming down in nearby Morgan County. “Doctor shopping” is a crime that involves using TennCare, the state’s public healthcare insurance program, to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.
The Office of Inspector General (OIG), with the assistance of the Morgan County Sheriff’s Office, today announced the arrest of Kathy Lynn Ellison, 53, of Harriman. She’s charged with three counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.” The drugs involved are the painkillers Hydrocodone and Lortab, with the doctor’s office visits being paid for by TennCare.
"The fraudulent misuse of TennCare benefits is a serious issue but Tennessee is out front in cracking down on these types of fraud crimes," Inspector General Deborah Y. Faulkner said. “Health care providers and their employees have become very good at spotting these cases and they’re as committed as we are to winning the war against TennCare fraud.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge. District Attorney General Russell Johnson will be prosecuting this case.
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."