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Marshall County Woman Charged with TennCare Fraud

Monday, December 30, 2013 | 02:55am

NASHVILLE, TN – A Marshall County woman is charged with TennCare fraud after receiving healthcare insurance benefits through the state’s Medicaid managed care program, even though she was not eligible for benefits.

The Office of Inspector General (OIG) today announced the charges against Gena Leigh Garton, 33, of Chapel Hill. She is charged with TennCare fraud and theft of services. Marshall County Sheriff’s Officers made the arrest.

The charge against Garton accuses her of receiving TennCare benefits for a year by fraudulently failing to disclose employment income to the state which would have made her ineligible for TennCare benefits. 

“People who misrepresent something about their current situation in order to qualify for TennCare are going to be caught and prosecuted,” Inspector General Deborah Faulkner said. “TennCare fraud is a felony, and a conviction could mean jail time, paying the state back for any medical services received, and possibly losing TennCare benefits for a period of time, even for those who qualify.”

The TennCare fraud charge carries up to a two-year sentence, and the theft of services charge could result in a sentence of up to 4 years. District Attorney General Robert Carter 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."

TennCare Fraud | Press Releases