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Grainger Co. Woman Charged with TennCare Fraud, Identity Theft

Tuesday, August 12, 2014 | 07:52am

NASHVILLE, Tenn. – A Grainger County woman is charged in Hamblen County with aiding and abetting another person in an illegal attempt to acquire TennCare healthcare insurance benefits they were not eligible to receive.

The Office of Inspector General (OIG) today announced the arrest of Maria Morales Santos, 39, of Washburn.  Her arrest was assisted by the Grainger County Sheriff’s Office.

Santos is accused of allowing a family member not eligible for TennCare to use another family member’s TennCare benefits to obtain medical assistance.  She is charged with four counts of TennCare fraud and two counts of identity theft.

“People may not think about the repercussions of committing TennCare fraud to receive medical care, but we are dedicated to ensuring that anyone involved in this activity will be caught,” said Acting Inspector General Lawrence S. Saylor, Jr. “We continue to aggressively investigate and prosecute anyone discovered committing TennCare fraud.” 

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge.  Identity theft is a Class D felony punishable by two to four years in prison per charge.  District Attorney General C. Berkeley Bell 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, 2,164 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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