Woman Charged with TennCare Fraud for the Third Time


Authorities have arrested two more people for TennCare fraud, and one of them is facing her third arrest on this charge.

This week the state’s Office of Inspector General, with the assistance of the Lexington Police Department, announced the arrest of Julie Rae Smith, 38, of Lexington.

Authorities charged Smith with 18 counts of TennCare fraud in Henderson County. In May of this year, authorities charged her with one count of TennCare fraud in Decatur County. Her first arrest was in November 2018, when she was charged with six counts of TennCare fraud in Madison County, according to a press release.

“All 25 charges of TennCare fraud by doctor shopping stem from an eight-month period in 2017, when authorities say Smith was treated on 54 separate dates by 32 different providers over a three-county area,” the press release said.

“During this time period, Smith used TennCare benefits to fraudulently obtain prescriptions for the painkillers Hydrocodone, Percocet, Tramadol, Codeine-Phospate, and Tylenol #3.  TennCare paid for the clinical visits and/or the prescriptions.”

District Attorney General Jody Pickens will prosecute the Henderson County charges. TennCare fraud is a Class D felony punishable by up to four years in prison per charge.

Agents with the Tennessee Bureau of Investigation, meanwhile, said an investigation of theirs’ has resulted in the indictment and arrest of a Memphis woman on charges of fraud and theft.

“At the request of the Division of TennCare’s Office of Program Integrity Unit in December of 2016, TBI Agents began investigating allegations that Duran Toney falsified documentation for TennCare services provided for a family member that were never received,” according to a TBI press release.

“During the course of the investigation, Agents developed information that timesheets were submitted by two former caregivers of Toney’s family member between January 2015 and February 2017.  However, Agents determined those services were never provided and the caregivers did not submit the timesheets.”

In July, the Shelby County Grand Jury returned indictments charging Toney with one count of Theft of Property over $60,000 and one count of TennCare Fraud of $60,000 or more.  She was booked into the Shelby County East Women’s Facility last month and released on her own recognizance.

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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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One Thought to “Woman Charged with TennCare Fraud for the Third Time”

  1. Randy Pace

    12 Billion dollars a year being pumped into TennCare. We can do better in the Volunteer State. Sending a message to individuals and providers alike is the only solution.