Jefferson Co. Woman Charged with 3rd TennCare Fraud Charge

Tuesday, August 05, 2014 | 06:24am

NASHVILLE, Tenn. – A Jefferson County woman is charged in both Knox and Hamblen Counties for TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for controlled substances.

The Office of Inspector General (OIG), assisted by the Hamblen and Knox County Sheriff’s Offices, today announced the arrest of Shirley Jean Whitehead, also known as Shirley Jean Barnes, 47, of Jefferson City.  She is charged in Knox County with doctor shopping and six counts of obtaining a controlled substance by fraud.  Barnes was transferred to Knox County from Hamblen County, where she is charged with two counts of doctor shopping.   In both incidents, Whitehead is accused of seeing multiple providers within a short period of time to obtain controlled substances, with the physician office visits or the prescriptions being paid for by TennCare.

Whitehead was first arrested by the OIG in April of this year when she was charged with doctor shopping in Jefferson County.   

“The unauthorized use and abuse of prescription drugs is something law enforcement and providers are focusing on statewide,” Acting Inspector General Lawrence S. Saylor, Jr., said. “We’re committed to ensuring that TennCare benefits are not used for the ultimate distribution of drugs through illegal sales.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge.  Obtaining a controlled substance by fraud is a Class D felony, carrying a sentence of up to four years in prison if convicted. District Attorney General C. Berkley Bell will be prosecuting the Hamblen County Case.  District Attorney General Randall Nichols is prosecuting the Knox County 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 TennCare, according to latest figures.  To date, 2,162 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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