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Davidson Co. Woman Charged with TennCare Fraud

Monday, February 23, 2015 | 07:09am

NASHVILLE, Tenn. – A Davidson County woman is charged with TennCare fraud after receiving healthcare benefits through the state’s healthcare insurance, even though she was not eligible for benefits.

The Office of Inspector General (OIG) today announced the arrest of Herendira Gonzalez Morales, who also used the name Herendira Gonzalez, 28, of Nashville.  She turned herself in to the Davidson County Sheriff’s Office.

Morales is charged with TennCare fraud and theft of services over $10,000. Charges say she received TennCare benefits by fraudulently failing to disclose her actual total income to the state, which would have made her ineligible for TennCare benefits.

“People who misrepresent something about their current situation in order to qualify for TennCare are going to be caught and prosecuted,” Inspector General Manny Tyndall said.  “TennCare fraud is a felony, and a conviction could mean jail time and/or paying the state back for any medical services received.”

The TennCare fraud charge carries up to two-year sentence in prison, and the theft of services charge could result in a sentence of up to 6 years.  District Attorney General Glenn Funk is prosecuting.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3 million being repaid to TennCare, with a total estimated cost avoidance of over $163.6 million for TennCare, according to latest figures.  To date, 2,294 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