Department of Finance & Administration
Mark Emkes, Commissioner

KNOX COUNTY COUPLE CONVICTED ON TENNCARE FRAUD CHARGES

NASHVILLE, Tenn. – A Knox County couple has pleaded guilty to TennCare fraud for concealing their total income in order to qualify for the state healthcare insurance program.

The Office of Inspector General (OIG) today announced that 37-year old Candice M. Lake, and Samuel Hereau, 38, each pleaded guilty to one count of TennCare fraud. Lake and Hereau both received to two-year sentences, suspended to supervised probation, and they must pay restitution to TennCare for healthcare services in the amount of $23,266.47 as well as about $1200 in court costs.  Charges against the couple said they intentionally underreported their household income in order to qualify for TennCare.  

“Lying about your income or your household circumstances to become eligible for a public healthcare insurance program is clearly criminal activity, and there’s a price to pay for it,” Inspector General Deborah Y. Faulkner said.  “Governor Bredesen established the OIG to eliminate this in TennCare, and he and the legislature have given us the tools to do so.”

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 1,000 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."