Department of Finance & Administration
Mark Emkes, Commissioner

DAVIDSON COUNTY WOMAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE – A Davidson County woman has been indicted in Sumner County for TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.

The Office of Inspector General (OIG) with the assistance of the Sumner County Sheriff’s Office and the Metropolitan Nashville Police Department today announced the arrest of Nancy F. Green, 54, of Madison.  She is charged with three counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.” Green failed to disclose to her doctor that she had seen other physicians within a 30-day period and received a prescription for the same or similar controlled substance – in this case, the painkiller Hydrocodone - with the physician office visits being paid for by TennCare.

"Tennesseans are demanding that prescription drug cases be targeted by law enforcement, and we have been weeding it out of TennCare for several years,” Inspector General Deborah Y. Faulkner said. “Health care providers and their employees have become very good at spotting these cases and they are as committed as we are to eliminating TennCare fraud.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge.   District Attorney General Lawrence R. Whitley will be prosecuting this case.

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."