Medicaid Fraud Control Division
For more than 25 years, the Agents and staff assigned to Medicaid Fraud have consistently identified more fraud dollars than the unit has spent. Every year, MFCU Agents remain aggressive in assisting TennCare recover millions of dollars in restitution for Tennesseans. Additionally, information obtained through patient abuse cases is used to compile the state’s Abuse Registry, which is managed by the Tennessee Department of Health.
The TBI investigates two types of Medicaid Fraud cases.
- Billing for medical services not actually performed
- Billing for a more expensive service than was actually rendered
- Billing twice for the same medical service
- Dispensing generic drugs and billing the Managed Care Organization for expensive brand-name drugs
- Kickbacks: Giving or accepting something in return for medical services
- Abuse or neglect of patients in facilities receiving funds from TennCare
Report An Allegation
To report TennCare provider fraud or patient abuse in Tennessee, call the TBI's Medicaid Fraud Control Unit Hotline at 1-800-433-5454.