Hamilton Co. Woman Charged with TennCare Doctor Shopping

Monday, October 21, 2013 | 10:54am

NASHVILLE, TN - A Hamilton County woman is charged with TennCare fraud involving doctor shopping - using TennCare healthcare insurance benefits to go to multiple doctors to obtain prescriptions for a controlled substance.

The Office of Inspector General (OIG) with assistance from the Hamilton County Sheriff, today announced the arrest of Joanna E. Killingsworth, also known as Joanna E. McGee, 29, of Chattanooga.  She is charged with five counts of fraudulently using TennCare to obtain a controlled substance by doctor shopping, and five counts of obtaining a controlled substance by fraud. 

Killingsworth is accused of seeing two or more doctors within a 30-day period in an effort to receive prescriptions for controlled substances, with the physician office visits, prescriptions or both being paid for by TennCare.

“We are glad to have the doctor-shopping law available to go after people who are involved in this activity in the TennCare program,” Inspector General Deborah Faulkner said.  “Other states don’t have this kind of tool and it’s helped us weed out some of the prescription drug abuse in TennCare.”

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 is a Class D felony, carrying a sentence of up to four years in prison if convicted. District Attorney General William H. Cox, III 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 1,900 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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