Former KY Couple Charged with TennCare Fraud

Monday, June 17, 2013 | 03:41am

NASHVILLE, TN – A former Kentucky couple is charged with misrepresenting their residency in order to obtain TennCare healthcare insurance and food stamp benefits.

The Office of Inspector General (OIG) today announced the arrest of James N. Houchin, 45, and his wife Ruby A. Houchin, 42, of Bethpage.  The Department of Human Services’ Special Investigations Division assisted with the case.

The Houchins were indicted by a Sumner County Grand Jury, charging them with TennCare fraud and theft of services, as well as food stamp fraud and theft of property in the amount of $23,436.00. 

Charges say the couple claimed they lived in Tennessee in order to appear eligible for TennCare benefits, although they were living in Kentucky, which would have disqualified them from getting benefits in Tennessee.

“For years, people thought there were hundreds or thousands of people living out of state and receiving TennCare benefits,” Inspector General Deborah Y. Faulkner said.  “The reality is that when that happens, we can detect it and bring charges against people for crossing the state line to get benefits in Tennessee.”

Illegally obtaining TennCare medical benefits and committing food stamp fraud are Class E felonies that carry a maximum penalty of two years in prison.  Theft of Services and theft of property over $10,000 but under $60,000 are Class C felonies that carry a maximum sentence of up to six years in prison. District Attorney General Lawrence R. Whitley 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 1,900 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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