Department of Finance & Administration
Larry B. Martin, Interim Commissioner

HICKMAN COUNTY MAN CHARGED WITH TENNCARE FRAUD

NASHVILLE, Tenn. - A Hickman County man is charged with using TennCare to pay for a fraudulent prescription in nearby Maury County.

The Office of Inspector General (OIG) today announced the arrest of Mark C. Setzer, 32, of Centerville, the result of a joint effort with the Hickman County Sheriff’s Office and the Maury County Sheriff’s Office.

Setzer is accused of presenting altered prescriptions for the painkillers Hydrocodone and Oxycodone at a pharmacy in Columbia, Tennessee, using a relative’s TennCare card to pay for the prescriptions.  He faces one count of TennCare fraud and two counts of obtaining a controlled substance by fraud.

“We have a zero tolerance for people who use TennCare to support prescription drug abuse,” Inspector General Deborah Y. Faulkner said. “We appreciate the hard work of the Hickman and Maury County Sheriff’s Offices for assisting the OIG in eliminating TennCare fraud.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison, and obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years per charge in prison. District Attorney General Mike Bottoms 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 1,100 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."