Davidson Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, TN – A Davidson County woman is charged with TennCare fraud involving doctor shopping, or using the state’s Medicaid healthcare insurance program to visit more than one doctor in a short period of time to obtain controlled substances.
The Office of Inspector General (OIG), with assistance from Metro Nashville Police, today announced the arrest of Michelle E. Birch, 49, of Nashville. She is charged with TennCare fraud and obtaining a controlled substance by fraud.
An indictment accuses Birch of fraudulently using TennCare benefits to obtain the controlled substance Norco, a brand version of the painkiller Hydrocodone, from multiple doctors, using TennCare as payment.
“The unauthorized use and abuse of prescription drugs is a problem across the nation, but Tennessee has laws to prosecute this activity in the state’s TennCare program,” Inspector General Deborah Faulkner said. “We’re committed to protecting TennCare benefits to provide important benefits to people who are in a situation where they need these services.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge. District Attorney General Victor S. Johnson, III, 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 2,100 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."