Mississippi Woman Charged with TennCare Fraud

NASHVILLE, TN – A Mississippi woman is charged with making false statements in order to obtain TennCare benefits.

The Office of Inspector General (OIG) today announced the arrest of Ana F. Rios, 38, of Olive Branch, Mississippi.  The Shelby County Sheriff’s Office assisted with the arrest.

Rios is charged in a Shelby County indictment with two counts of TennCare fraud and one count of theft of property. The charges accuse her of making false statements in order to enroll in the TennCare program, and using the program’s healthcare insurance benefits even though she was not eligible.  

“Healthcare insurance and access to medical benefits is a valued resource, and the state provides this for people who are truly eligible for the taxpayer-funded program,” Inspector General Deborah Y. Faulkner said.  “We will fully pursue any case where someone is misrepresenting their income, address or employment to gain TennCare benefits.”

Illegally obtaining TennCare medical benefits is a Class E felony that carries a maximum penalty of two years in prison per charge. Theft of Property over $10,000 but under $60,000 is a Class C felony that carries a maximum sentence of up to six years in prison. District Attorney General Amy P. Weirich will prosecute.

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."