Tennessee Officials Charge Even More People with TennCare Fraud

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The number of people state officials have charged with TennCare fraud continues to grow, meaning state taxpayers still subsidize alleged waste, fraud, and abuse out of the program.

This, according to two press releases the Tennessee Office of Inspector General released this week.

Authorities charged a Wilson County woman with TennCare fraud in both Wilson and Davidson counties because of the woman’s alleged doctor shopping for controlled substances.

OIG officials said that woman, Datha Kimberly Robertson, 26, of Lebanon, used TennCare to doctor shop for the painkiller Oxycodone. A Wilson County indictment accuses her of three counts of fraudulently using TennCare to doctor shop.

“Upon posting bond, Robertson was arrested for the second time in Davidson County, where she faced an indictment charging her with two counts of TennCare fraud for doctor shopping for the painkiller Hydrocodone; and, one count of obtaining a controlled substance by fraud,” according to the press release.

“Authorities say that during a six-week period, Robertson had five visits to a hospital emergency room, doctor’s offices and urgent care.  In each of the incidents, she used TennCare to obtain controlled substances, while failing to disclose that she’d received previous similar drugs.  The charges in both counties are pending adjudication.”

OIG officials also announced that a Hancock County man, Larry Seal, 35, of Sneedville, allegedly sold prescription drugs he obtained using TennCare benefits.

“He (Seal) is charged with using TennCare benefits to obtain the painkiller Oxymorphone, which is a Schedule II controlled substance, then selling the drugs on four separate occasions,” according to the press release.

“Seal is charged with four counts of TennCare fraud.  The prescriptions were obtained through Medicare Part B, which is paid for in part by TennCare.”

TennCare fraud is a Class D felony punishable by up to four years in prison per charge.

“The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to more than $3 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures,” according to a press release.

“To date, 3,115 people have been charged with TennCare fraud.”

As The Tennessee Star reported this month, a Mississippi woman allegedly committed more than $250,000 worth of TennCare fraud, according to Tennessee officials, and she must pay that money back.

As reported last month, the Bureau of TennCare overpaid more than $600,000 to a now-closed health care clinic in Madisonville.

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected]

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3 Thoughts to “Tennessee Officials Charge Even More People with TennCare Fraud”

  1. […] The Tennessee Star reported, the number of people state officials have charged with TennCare fraud continues to grow, meaning […]

  2. 83ragtop50

    $3 million being repaid out of how much stolen?

    Has anyone of the thieves served jail time? I doubt it.

    TennCare is a blight on the state.

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