Humphreys Co. Woman Must Repay State for TennCare Benefits

Friday, November 15, 2013 | 02:40am

NASHVILLE, TN - A Humphreys County woman charged with TennCare fraud in both Humphreys and Wilson Counties has been ordered to repay the state for benefit received from the healthcare insurance program.

Lisa A. Herlein, 39, of McEwen, was most recently charged in July by the Office of Inspector General (OIG) in Wilson County in connection with falsely claiming dependent children in order to qualify for TennCare benefits.  She was charged with TennCare fraud and theft of services.  In December of last year, she was charged in Humphreys County with two counts of TennCare fraud for concealing material facts in order to obtain TennCare benefits.  At that time, she was also charged with theft of services.  

Herlein pleaded guilty to two counts of TennCare fraud, and was ordered to repay the state a total of $24,447.48, and is on supervised probation for two years and judicial diversion for four years.  Her cases were prosecuted by District Attorney Generals Dan M. Alsobrooks and Tom P. Thompson.

 “It is troubling that anyone with resources would try to get enrolled in a program meant for people who truly need healthcare benefits through TennCare,” Inspector General Deborah Faulkner said. “We’re pursuing cases like this across Tennessee.”

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 2,000 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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