Claiborne Co. Man Charged with TennCare Drug Fraud

Wednesday, January 02, 2013 | 06:56am

NASHVILLE, TN – A Claiborne County is charged with TennCare fraud for using the state’s public health insurance program to obtain prescription drugs, which he later sold.

The Office of Inspector General (OIG), with assistance from the Claiborne County Sheriff’s Office, today announced the arrest of Manning Andrew Sizemore, Jr., 39, of New Tazewell.  He is accused in an indictment of TennCare fraud, sale of a Schedule II controlled substance and delivery of a Schedule II controlled substance. 

Sizemore is charged in connection with presenting a prescription for the painkiller Oxymorphone, using TennCare to pay for the prescription, while planning to sell a portion of the drug.

“This is another example of local law enforcement coming to our office for assistance when TennCare fraud is suspected,” Inspector General Deborah Faulkner said. “Everyone, including local law enforcement, can ask for our assistance or let us know when they suspect TennCare fraud.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison. Sale of a Schedule II controlled substance and delivery of a Schedule II controlled substance both are Class C felonies that carries a sentence of up to six years. District Attorney General Lori Phillips-Jones 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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