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Jefferson Co. Woman Charged with TennCare Doctor Shopping

Friday, April 25, 2014 | 06:27am

NASHVILLE, TN – A Jefferson County woman is charged with TennCare fraud involving doctor shopping, or using the state’s Medicaid healthcare insurance program to pay for multiple physician visits in order to obtain controlled substances.

The Office of Inspector General (OIG), with assistance from the Jefferson County Sheriff’s Office, today announced the arrest of Shirley J. Whitehead, 46, of Jefferson City.

Whitehead is charged with visiting multiple doctors within a 30-day period in order to obtain controlled substances, using TennCare benefits to pay for either the physician office visits or the controlled substances. 

“The unauthorized use and abuse of prescription drugs obtained with TennCare benefits is a serious crime and a priority concern in communities across the state,” Inspector General Deborah Faulkner said.  “We are committed to ensuring that TennCare benefits are not used to put drugs in the wrong hands.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison. District Attorney General James Dunn 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, 2,095 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