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Henry County Nurse Charged with TennCare Fraud

Wednesday, May 15, 2013 | 04:04am

NASHVILLE, TN – A registered nurse from Henry County is charged with TennCare fraud for illegally dispensing medication, costing the healthcare program nearly $10,000 in payments for the drugs.

The Office of Inspector General (OIG) today announced the arrest of Gene Gaylor Dougherty, 31, or Paris, TN.  The McKenzie Police Department assisted in the arrest. 

Dougherty worked as a nurse at McKenzie Regional Hospital when the crime allegedly occurred.  Charges say he found a way of illegally dispensing medication in amounts not approved by prescribing medical professionals at the hospital.  As a result, TennCare paid for unauthorized medications in an amount totaling $9,881.93.

“Doctors, hospitals and pharmacists are all helping us track episodes of TennCare fraud, and it’s led to the success we’ve had in trying to eliminate this problem in TennCare,” Inspector General Deborah Y. Faulkner said.  “Providers, law enforcement and citizens are more alert to some of the tactics used to commit TennCare fraud, and they are helping us preserve TennCare.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison. District Attorney General Hansel J. McCadams 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 1,700 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