Two Davidson County Residents Charged with TennCare Fraud

Friday, June 22, 2012 | 08:52am

NASHVILLE – Two Davidson County residents are charged with TennCare fraud for filling fraudulent prescriptions and using TennCare to pay for them.  The Office of Inspector General (OIG), along with help from Metro Nashville Police, today announced the arrest of April D. Sanderson, 38, and Zachary Eatherly, 20, both of Nashville.

Sanderson was charged with three counts of TennCare fraud, eight counts of identity theft, and 16 counts of obtaining possession of a controlled substance by fraud.  The charges against Sanderson say she fraudulently obtained the strong painkiller Lortab and the anti-anxiety medication Alprazolam by using the identity of medical providers without authorization to do so.  In all instances, she used TennCare benefits to pay for the forged prescriptions.

On the same indictment, Eatherly was charged with two counts of TennCare fraud, two counts of identity theft, and four counts of obtaining possession of a controlled substance by fraud. Charges say he obtained both Lortab and Alprazolam by means of forgery bearing the identity of medical providers without authorization, using TennCare to pay for the forged prescriptions.

“This type of criminal activity is outrageous and will not be tolerated by the Office of Inspector General, local law enforcement, or healthcare providers,” Inspector General Deborah Faulkner said.   “We encourage anyone who is aware of this type of activity to contact the OIG for investigation and subsequent prosecution.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. Obtaining a controlled substance by fraud and identity theft both are Class D felonies that carries a sentence of up to four years in prison per charge. District Attorney Victor S, Johnson, III 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, over 1,600 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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