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 the assistance of the Knox County Sheriff’s Office, today announced the arrest of Karen Denise Kyle, also known as Karen Isom, age 56, of Knoxville. Kyle is charged with five counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”  She saw multiple physicians within a 30-day period, receiving the same or similar controlled substances with the physician office visits, prescriptions, or both being paid for by TennCare.  In addition, Kyle was also charged with six counts of attempting to obtain possession of a controlled substance by fraud.

“People don’t always think of prescription drugs, especially painkillers, as particularly harmful, but abuse of these kind of drugs can have a very dramatic effect on a person,” Inspector General Deborah Y. Faulkner said.

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison.  Obtaining a controlled substance by fraud is a Class D felony that carries a sentence of up to four years in prison.  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 $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, over 1,400 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."