Davidson County Woman Charged with TennCare Fraud

Friday, December 21, 2012 | 05:47am

NASHVILLE, TN – A Davidson County woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through TennCare, even though she did not qualify for the program. This arrest brings the total number of people arrested for TennCare fraud to 1,800 since the Office of Inspector General (OIG) began investigating and pursuing this criminal activity.

With the assistance of the Nashville Metropolitan Police Department, the OIG today announced the arrest of Ryan Deette Wagoner, 29, of Nashville. She is charged with one count of TennCare fraud and one count of theft of services over $10,000.

Wagoner is charged with TennCare fraud for concealing material facts in order to obtain TennCare medical benefits to which she was not entitled to receive.  In addition, Wagoner has been charged with theft of services over $10,000 for knowingly and feloniously obtaining services by deception, fraud, coercion, false pretense or by other means to avoid payment for services.  TennCare paid for the services, even though she was not eligible.  

“We will keep working cases until those who commit these crimes against TennCare get the message that we won’t tolerate this activity,” Inspector General Deborah Y. Faulkner said. “We have made twenty-two arrests this month and we have many more cases in the pipeline.”

The TennCare fraud charge carries up to a two-year sentence, and the theft of services charge could result in a sentence up to six years. District Attorney General Victor S. Johnson, 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, over 1,700 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."

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