Tipton Co. Woman Charged with TennCare Doctor Shopping

Friday, December 20, 2013 | 07:39am

NASHVILLE, TN – A Tipton County woman is charged in nearby Dyer County for TennCare fraud involving doctor shopping, or going to multiple doctors to obtain controlled substances and using the state’s Medicaid program as payment.

The Office of Inspector General (OIG), with assistance from the Dyer County Sheriff’s Office, today announced the arrest of Kristy Morrow Valley, also known as Kristy Morrow Roberts, 32, of Drummonds.  She is charged with fraudulently using TennCare to obtain controlled substances by doctor shopping for the painkiller Hydrocodone.  TennCare paid for both the office visits and for the controlled substance.

“Prescription drug abuse is not tolerated in the state’s TennCare program, and we are intent on pursuing people involved in this crime,” Inspector General Deborah Faulkner said. “The Office of Inspector General is committed to ensuring that TennCare benefits are used appropriately, for people who truly need healthcare services.”

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