Department of Finance & Administration
Mark Emkes, Commissioner

KNOX COUNTY WOMAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE – A Knox County woman is charged with TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.

The Office of Inspector General (OIG), with assistance of the Knox County Sheriff’s Office, today announced the arrest of Wednesday Michelle Hawkins, 22, of Knoxville. Hawkins is charged with four counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping” and four counts of obtaining a controlled substance by fraud.  Hawkins failed to disclose to her doctor that she had seen other physicians within a 30-day period and received prescriptions for the same or similar controlled substances, with the physician office visits being paid for by TennCare.

"We are delighted with the response we have received from physicians across the state in support of cracking down on people who try to doctor shop,” Inspector General Deborah Faulkner said. “Before the doctor shopping law, a medical provider’s hands were tied and now they are calling us, often as soon as the patient leaves the office.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge, and obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years in prison per charge. District Attorney General Randall E Nichols 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."