Tennessee officials report they have charged residents of Lincoln, Shelby, and Sullivan counties with TennCare fraud.
They also charged a Sweetwater resident with a similar crime, according to another statement.
Office of Inspector General officials said Amy Wharton, 40, of Fayetteville, allegedly sold drugs obtained through TennCare healthcare insurance benefits. Officials charged her with one count of TennCare Fraud, a class D felony..
An indictment accuses Wharton of knowingly using TennCare benefits to obtain the anti-anxiety medication Alprazolam, also known as Xanax, then selling a portion of the drug to a confidential informant.
If convicted, Wharton could face penalties of up to a maximum of 12 years in prison for the charge.
In Memphis, Tisa R. Thomas, 39, allegedly falsely reported her income and marital status to enroll herself and her daughter for TennCare benefits. Authorities charged Thomas with TennCare fraud, a class D felony, and theft of services over $10,000 but under $60,000, a class C felony.
“Investigators say Thomas was employed and over the income threshold to legally enroll herself and her daughter in TennCare, which resulted in TennCare paying $22,576.47 on their behalf,” the statement said.
If convicted of the charges, Thomas could face penalties of up to 27 years in prison.
A Sullivan County woman, meanwhile, was charged for allegedly filing false information in order to appear eligible for the healthcare insurance program.
“She’s accused of falsely reporting her marital status in order to obtain TennCare benefits for herself and her two children,” according to a press release.
“Investigators say if she had correctly reported her husband’s income contribution to the household, she would not have been eligible for the program. The result, authorities say, is that TennCare paid $57,800.21 on their behalf.”
The theft of services charge is a class C felony and the TennCare fraud charge is a class D felony. If convicted, Marion could face penalties of up to a maximum of 27 years in prison, the press release said.
In another press release, OIG officials said a Sweetwater woman was charged with TennCare fraud in connection with allegedly doctor shopping for drugs. Doctor shopping involves visiting multiple physicians to obtain multiple prescriptions for prescription drugs.
That woman, Jennifer Rodriguez-Howard, 43, also known as Jennifer L. Drew, is charged with two counts of TennCare fraud for allegedly visiting multiple physicians within a 30-day period in an effort to obtain controlled substances, the press release said.
If convicted, Rodriguez-Howard could face up to a maximum of 24 years in prison for the two counts of TennCare fraud, which are both class D felonies, according to the press release.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated over 5,760 criminal cases leading to more than $10.8 million ordered in restitution to TennCare. This has helped lead to a total estimated cost avoidance of more than $163.6 million for TennCare, according to the latest figures. To date, 3,137 people have been charged with TennCare fraud, according to a press release.
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 or by logging on to www.tn.gov/oig/ and following the prompts that read “Report TennCare Fraud.”
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