Sumner Co. Man Charged 3rd Time with TennCare Doctor Shopping

Wednesday, October 02, 2013 | 08:57am

NASHVILLE, TN - A Sumner County man is charged with TennCare fraud involving doctor shopping, for the third time in less than three months.

The Office of Inspector General (OIG) today announced the arrest of 42-year old John P. Lamb.  He is accused in an indictment with fraudulently obtaining a controlled substance by doctor shopping for the painkiller Hydrocodone, using TennCare to pay for the doctor’s office visits or the prescriptions. Earlier this month, he was charged with doctor shopping in Davidson County.  And in July, he was charged with doctor shopping in a Wilson County indictment.

“Law enforcement officers and healthcare providers today have more knowledge and tools to stop this kind of crime, especially as it relates to public healthcare dollars,” Inspector General Deborah Faulkner said.  “The citizens of the state have zero tolerance for this kind of abuse in the state’s TennCare program.”  

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison.  District Attorney General Lawrence W. Whitley will be prosecuting the Sumner County case.

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 1,900 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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