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Shelby Co. Man Charged with TennCare Doctor Shopping

Tuesday, July 29, 2014 | 06:09am

NASHVILLE, Tenn. – A Shelby County man is charged in with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances.

The Office of Inspector General (OIG), with the assistance from the Shelby County Sheriff’s Office, today announced the arrest of Kevin Q. Holmes, of Memphis.  He is charged with two counts of doctor shopping.  In addition, Holmes was charged with theft of property.  The indictment against him says Holmes used TennCare healthcare insurance benefits to pay for either the clinical visits or the prescriptions.

“We have more tools today to detect prescription drug activity, and along with the doctor shopping law, it’s hard to commit this crime without getting caught,” Acting Inspector General Lawrence S. Saylor, Jr., said.  “Those who get caught will pay for the crime.”                                                

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge.  Theft of property over $1,000 is a Class D felony punishable by up to four years in prison.  District Attorney General Amy T. Weirich 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 TennCare, according to latest figures.  To date, 2,155 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