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Sumner County Man Charged with TennCare Fraud

Wednesday, July 17, 2013 | 09:26am

NASHVILLE, TN – A Sumner County man is charged in Wilson County with TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.

The Office of Inspector General (OIG) with the assistance of the Wilson County Sheriff’s Office, today announced the arrest of John P. Lamb, 42, of Gallatin.  He is charged with TennCare fraud and two counts of obtaining a controlled substance by fraud for doctor shopping for drugs, with the physician office visits, the prescriptions or both being paid for by TennCare.

"We are winning the war against TennCare fraud, and the front line of that battle is prescription drug fraud," Inspector General Deborah Faulkner said. "We will vigorously prosecute people accused of committing all TennCare fraud as well as those who attempt to abuse the program."

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison. Obtaining a controlled substance by fraud is a Class D felony that carries a sentence of up to four years in prison.  District Attorney General Tom P. Thompson 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 1,900 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."

TennCare Fraud | Press Releases