Department of Finance & Administration
Mark Emkes, Commissioner

DAVIDSON CO. WOMAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE, TN – A Davidson 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 the assistance of Metro Nashville Police, announced the arrest of Carolyn Jean Benford, also known as Carolyn Grimes Benford, 61, of Nashville. Benford is charged with four counts of fraudulently using TennCare to obtain controlled substances by "doctor shopping." Officials say she saw multiple physicians within a 30-day period and received prescriptions for the strong painkillers Hydrocodone and Opana, with the prescriptions or clinical visits being paid for by TennCare.

"We are cracking down on this activity in TennCare, and intend to pursue all drug fraud cases to prosecute fully," Inspector General Deborah Y. Faulkner said.

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney General Victor S. Johnson 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 1,600 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."