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Roane County Woman Charged with TennCare Fraud

Wednesday, August 08, 2012 | 07:06am

NASHVILLE – A Roane County woman is charged with TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.

The Office of Inspector General (OIG), with the assistance of the Roane County Sheriff’s Office, today announced the arrest of Jessica L. Hall, 36, of Harriman.  Charges say she fraudulently used TennCare to obtain controlled substances by failing to tell her doctor she had seen other physicians and received prescriptions for the painkiller Hydrocodone, with the physician office visits being paid for with TennCare benefits.

“TennCare is an important program for people who need help covering healthcare costs and qualify for the benefit,” Inspector General Deborah Faulkner said. “But to preserve it for people who need it and are eligible, we have to weed out those people who are abusing it to get painkillers for themselves or to sell to others.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge.  District Attorney General Russell Johnson 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."

TennCare Fraud | Press Releases