Sullivan Co. Woman Charged with TennCare Fraud

NASHVILLE, TN – A Sullivan County woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through TennCare, even though she was not eligible for the program.

The Office of Inspector General (OIG) today announced the arrest of Michelle Davis, 35, of Bristol. She is charged with TennCare fraud and theft of services. The Sullivan County Sheriff’s Office assisted in Davis’ arrest.

The charges say Davis received TennCare benefits by means of a willfully false statement or by other fraudulent means.  Davis fraudulently claimed her minor children as members of her household in order to be eligible 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, a conviction could mean jail time and repaying the state for any medical services received.”

The TennCare fraud charge and the theft of services charge are both Class E felonies that could result in a sentence of up to two years in prison per charge.  District Attorney General Barry P. Staubus 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."