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

DAVIDSON COUNTY MAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE – A Davidson County man is indicted for 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 today announced the arrest of James Clinton Grogan, Sr., 42, of Madison. He is charged with three counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”

Charges against him say Grogan failed to tell his doctor he had seen another physician recently, receiving prescriptions for the painkillers Oxycodone and Lortab. Either the office visits, the prescriptions, or both were paid for by TennCare. Grogan was also charged with two counts of TennCare fraud for obtaining medical assistance benefits by means of a willfully false statement, representation or impersonation or by concealment of a material fact, or by other fraudulent means.

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison per charge.  District Attorney Victor “Tory” S. Johnson 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, nearly 1,500 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."