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Kentucky Man Charged with TennCare Fraud

Friday, February 27, 2015 | 05:26am

NASHVILLE, Tenn. – A Kentucky man is charged with TennCare fraud in Montgomery County, Tennessee. 

The Office of Inspector General (OIG) today announced the arrest of Rene Gonzalez, 44, of Elkton, Kentucky.  He’s accused of falsifying his TennCare application and recertification documents by saying that he lived in Tennessee, even though his residence was actually in Kentucky.  During that time, he and his family received TennCare healthcare insurance benefits totaling more than $10,000.

Gonzalez is charged with five counts of TennCare fraud and one count of theft of services over $10,000.  He was booked into the Montgomery County Jail and has since posted bond.

“We intend to prosecute anyone, regardless of where they live, if they lie to get enrolled in TennCare,” Inspector General Manny Tyndall said.  “People who cross the state line to gain benefits available to Tennessean’s aren’t just stealing; they’re hurting the TennCare program.

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. Theft of service over $10,000 is a Class C felony that carries a maximum sentence of six years in prison.  District Attorney General John W. Carney 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, 2,297 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