Department of Finance & Administration
Mark Emkes, Commissioner

KNOX COUNTY WOMAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE - A Knox County woman is under indictment for TennCare fraud involving “doctor shopping,” or using the public healthcare insurance program to go to multiple doctors in a short time period to obtain controlled substances.

The Office of Inspector General (OIG), with assistance from the Knox County Sheriff’s Office, today announced the arrest of Nancy E. Horsley, 46, of Corryton.  She is charged with six counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”

Horsley is accused of going to multiple physicians within a 30-day period, receiving prescriptions for the same or similar controlled substances, with the clinical visits being paid for by TennCare.

"We are enthused with the response we’ve received from physicians across the state in support of cracking down on people who try to ‘doctor shop’,” Inspector General Deborah Faulkner said. “Before the ‘doctor shopping’ law, physicians’ hands were tied and now they’re calling us, often as soon as the patient leaves the office.”

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney General Randall 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, 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."