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Two People in East Tennessee Charged with TennCare Fraud

Friday, April 10, 2015 | 05:24am

NASHVILLE, Tenn. – Two people in East Tennessee are charged with TennCare fraud in cases involving prescription drugs.

The Office of Inspector General (OIG) today announced the arrests in Knox and Bradley Counties, both involving doctor shopping, which is the act of visiting multiple physicians in a short period of time to obtain prescription drugs, using TennCare as payment.

In Bradley County, Elizabeth A. Lamb, 36, of Decatur in Meigs County is charged with two counts of doctor shopping. The Bradley County Sheriff’s Office assisted in her arrest. District Attorney General Stephen D. Crump is prosecuting.

In Knox County, Darrell Pitts, 55, of Knoxville, is charged with two counts of doctor shopping for the strong painkiller Oxycodone, using TennCare as payment. He is also charged with two counts of obtaining a controlled substance by fraud.  District Attorney General Charme P. Allen is prosecuting.

“The abuse of TennCare benefits, especially to obtain pain medications, is our number one priority, “Inspector General Manny Tyndall said.  “Local police, providers and the healthcare community are with us in the effort to weed this problem out of the TennCare program.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge.

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, 2,327 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."