Hamilton Co. Woman Charged with TennCare Doctor Shopping

Monday, June 16, 2014 | 05:05am

NASHVILLE, TN – A Hamilton County woman is charged with TennCare fraud involving “doctor shopping,” or going to multiple doctors in a short period of time to obtain prescription drugs and using TennCare as payment.

The Office of Inspector General (OIG) with the assistance of the Hamilton County Sheriff’s Office, today announced the arrest of Jama Denise Burton also known as Jama Denise Miller, 42, of Harrison.  Miller is charged with eight counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”  She is also charged with eight counts of obtaining a controlled substance by fraud.

"Tennessee communities no longer tolerate the fraudulent misuse of prescription drugs, especially when TennCare is involved," Acting Inspector General Robert White said. "We are working closely with local law enforcement agencies and medical providers across the state to investigate and prosecute these types of crimes."

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge, and obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years in prison per charge. District Attorney General William H. Cox, 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, 2,123 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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