Department of Finance & Administration
Mark Emkes, Commissioner

KNOX COUNTY WOMAN CHARGED WITH 16 COUNTS OF TENNCARE "DOCTOR SHOPPING"

NASHVILLE - A Knox County woman has been indicted for TennCare fraud involving “doctor shopping” for drugs, using TennCare to pay for multiple doctor visits 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 Sandra Elaine Lawson, also known as Sandra Rose Jones or Sandra Elaine Burchfield, age 58, of Knoxville.

Lawson is charged with 16 counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.” She saw multiple physicians within 30 days, receiving prescriptions for the same or similar controlled substances.

"The fraudulent misuse of TennCare benefits is a serious issue but the OIG is being aggressive in cracking down on these crimes," 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 involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison per charge.  Obtaining a controlled substance by fraud is a Class D felony that carries a sentence of up to four years per charge 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."