Hamilton County Man Charged with TennCare Fraud

NASHVILLE, Tenn. – A Hamilton County man is charged with TennCare fraud and elder abuse in connection with taking an elder woman’s assets so the state would pay for her nursing home care. 

The Office of Inspector General (OIG) today announced the arrest of Jack Carl Riggins, 67, of East Ridge.  He was charged in White County, which is about 80 miles north of Hamilton County.  The Hamilton and White County Sheriff’s Offices assisted in the arrest.

In a three-count indictment, Riggins is accused of transferring an elderly woman’s assets and resources to himself, using a durable power of attorney.  This transfer of assets made the woman eligible for TennCare healthcare insurance benefits, which includes nursing home care.  Riggins is charged with TennCare fraud, theft of services over $60,000 and elder abuse by means of exploitation. 

"TennCare provides specialized care for low-income people who are truly eligible and need assistance - people who have few or no assets," Acting Inspector General Lawrence S. Saylor, Jr., said. "Many people want to preserve their assets for children or other beneficiaries, but federal law prohibits this kind of 'pauperizing' of a person to trigger government aid for expensive long-term care."

Both TennCare fraud and elder abuse are Class E felonies, carrying a sentence of up to two years in prison per charge. Theft of services over $60,000 is a Class B felony, punishable by up to twelve years in prison.  District Attorney General Bryant C. Dunaway is prosecuting.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $5 million being repaid to TennCare, with a total estimated cost avoidance of over $176 million for TennCare, according to latest figures.  To date, 2,184 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."