Department of Finance & Administration
Mark Emkes, Commissioner

RUTHERFORD WOMAN TO FACE TENNCARE FRAUD CHARGES

NASHVILLE – A Rutherford County woman has been transferred to her home county from federal custody to face a 22-count indictment involving TennCare fraud.

The Office of Inspector General (OIG) and the Rutherford County Sheriff today announced the arrest of Mallary Waldon, 24, of Smyrna.  Charges against Waldon resulted from a year-long investigation which also focused on a woman named Stacy Rayfield, who is a former nurse practitioner at the La Vergne Medical Clinic.   Rayfield was the alleged “ringleader” in the case, where Waldon and two other employees obtained prescriptions for the painkiller Lortab, along with the anti-anxiety medication Xanax and the stimulant Phentermine, also used as a diet pill.  None of the employees receiving the prescriptions were ever patients at the clinic.  The prescriptions were all written by Rayfield and TennCare was used to purchase them.  For her part, Waldon has been charged with 19 counts of prescription fraud and three counts of TennCare fraud.

“It’s troubling when healthcare workers are alleged to be involved in drug fraud, particularly TennCare drug fraud,” Inspector General Deborah Y. Faulkner said.  “We are intent on bringing these folks to justice.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge, obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years in prison per charge. District Attorney General William C. Whitesell, Jr. is prosecuting.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $2.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $171 million for the TennCare program, according to latest figures.  To date, over 1,300 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."