Department of Finance & Administration
Mark Emkes, Commissioner

JEFFERSON CO. CASE BRINGS TENNCARE FRAUD ARRESTS TO 1300

NASHVILLE TN - A Jefferson County man is charged with TennCare fraud involving "doctor shopping," bringing to 1300 the number of people arrested for TennCare fraud since the Office of Inspector General (OIG) began investigating and pursuing this criminal activity.

The OIG with assistance from the Jefferson County Sheriff´s Office today announced the arrest of John E. Adkins, Jr., 36, of Dandridge. Adkins is charged with two counts of fraudulently using TennCare to obtain a controlled substance by "doctor shopping." An indictment says he failed to disclose to his doctor that he had seen other physicians within a 30-day period and received a prescription for the strong painkiller Lortab, with the physician office visits being paid for by TennCare.

"We knew the "doctor shopping," law would be a valuable tool for us, but we couldn´t have predicted the number of cases we´ve brought to justice since the law was passed by the Legislature," Inspector General Deborah Faulkner said. "Part of our success in this area is due to physicians and pharmacists who have eagerly helped us develop these cases."

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney General James Dunn will be prosecuting this case.

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 1,240 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."