Cumberland County Woman is 1,700-th Arrest for TennCare Fraud

Tuesday, July 17, 2012 | 09:49am

NASHVILLE – A Cumberland County woman is charged with TennCare fraud involving “doctor shopping,” or going to multiple doctors in a short period of time to obtain prescription drugs.  The arrest brings the total number of people arrested for TennCare fraud to 1,700 since the Office of Inspector General (OIG) began investigating and prosecuting this criminal activity.

In a joint investigation with the Cumberland County Sheriff’s Office, the OIG today announced the arrest of Patricia R. Martin, 35, of Crossville. Martin is charged with one count of fraudulently using TennCare to obtain controlled substances by “doctor shopping” for the strong painkiller Oxycodone, with the medications being paid for by TennCare. 

“The Office of Inspector General will do everything in our power to stop the unauthorized use and abuse of the TennCare program especially as it relates to prescription drugs,” Inspector General Deborah Faulkner said. “Anyone who is aware of this criminal activity can contact the OIG, even anonymously.”

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison, and obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years in prison per charge. District Attorney General Randall York 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, 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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