Knox County Man Charged with TennCare Doctor Shopping
NASHVILLE, TN – A Knox County man is charged 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 Knox County Sheriff’s Office, today announced the arrest of Jonathan Dale Presnell, 33, of Knoxville. He is charged with six counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.” In addition, Presnell was charged with six counts of obtaining a controlled substance by fraud.
"We receive outstanding response from physicians and other providers across the state with our efforts to crack down on people who ‘doctor shop’ in the TennCare program,” Acting Inspector General Robert White said. “Tennesseans are fortunate to have this tool we can use against fraud in our public healthcare insurance program.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison, 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 Randall Nichols 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, 2,118 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."