Department of Finance & Administration
Mark Emkes, Commissioner

HAMBLEN COUNTY GRAND JURY CHARGES TWO WITH TENNCARE FRAUD

NASHVILLE – Two people are charged by a Hamblen County Grand Jury with TennCare drug fraud.   A man and woman are accused of selling prescription drugs paid for by TennCare, the state’s public healthcare insurance program.

The Office of Inspector General (OIG) today announced the arrest of Kathy L. Gordon, also known as Kathy Seals, age 55, and Zendell E. Seals, age 52, both of Sneedville. The arrests are the result of a joint effort with the Hancock County Sheriff’s Office and the Hamblen County Sheriff’s Office.

Both Gordon and Seals are accused in separate indictments of fraudulently obtaining prescription drugs, using TennCare benefits as payment.  The indictments say that Gordon used TennCare benefits to obtain the strong pain medication Oxycodone; and, that Seals used TennCare to pay for the painkillers Morphine and Oxycodone.  After obtaining the prescriptions, the charges say both individuals resold a portion of the pills to a confidential informant.  Gordon has been charged with one count of TennCare fraud.  Seals is charged with two counts of TennCare fraud.

“TennCare enrollees who participate in selling drugs paid for by the TennCare program, and those who buy them, should understand this is a serious crime and the OIG intends to uncover this fraud and prosecute,” Inspector General Deborah Y. Faulkner said.  “Tennessee has taken a zero tolerance posture in laws that aim to protect TennCare from fraud.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge.  District Attorney General C. Berkeley Bell is prosecuting.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $173 million for the TennCare program, according to latest figures.  To date, nearly 1,500 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."