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Alabama Woman Must Repay State After TennCare Fraud Confiction

Wednesday, August 20, 2014 | 09:52am

NASHVILLE, Tenn. – An Alabama woman charged with TennCare fraud for claiming to live in Tennessee must now repay the state over $54,000 for healthcare insurance benefits paid on her behalf by TennCare.

The Office of Inspector General (OIG) today announced that Melissa Burns, 38, of Florence, Alabama, must repay the state for payments made due to healthcare services she and her family received while they were on TennCare.  A Wayne County Criminal Court ordered Burns to repay TennCare a total of $54,225.30.  In addition, she was ordered to serve six months in jail, and afterward report to a probation officer until the year 2030.

Burns was arrested in April and charged with seven counts of TennCare fraud and two counts of theft of property for intentionally misrepresenting that she and her family lived in Tennessee, when in fact they lived in Alabama.

“The TennCare program is for eligible people who live in Tennessee,” Acting Inspector General Lawrence S. Saylor, Jr., said.  “Anyone who intentionally misrepresents themselves to enroll in TennCare – and receive medical benefits through the program – will be prosecuted to the fullest extent of the law.”

District Attorney General Mike Bottoms prosecuted this case.

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, 2,167 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 and follow the prompts that read "Report TennCare Fraud."

TennCare Fraud | Press Releases