Knox Co. Woman Charged with Ten Counts of TennCare Fraud

Thursday, February 05, 2015 | 05:28am

NASHVILLE, Tenn. – A Knox County woman is charged with TennCare fraud involving doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment.

The Office of Inspector General (OIG), assisted by the Knox County Sheriff’s Office, today announced the arrest of Mary E. Wilder, 37, of Knoxville.  She is charged with ten counts of fraudulently using TennCare to obtain controlled substances by doctor shopping for drugs, which involves going to multiple doctors in a short period of time seeking prescriptions for controlled substances. She was also charged with ten counts of obtaining a controlled substance by fraud.

“The fraudulent misuse of TennCare benefits is a serious issue, but the OIG is being aggressive in cracking down on these crimes.”  Inspector General Manny Tyndall said.  “Healthcare providers and their employees have been exceptional at spotting these cases and they are as committed as we are in eliminating TennCare fraud.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. District Attorney General Charme P. Allen 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, 2,281 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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