|FOR IMMEDIATE RELEASE
TUESDAY, DECEMBER 30, 2008
CONTACT: LOLA POTTER
NASHVILLE, Tenn. – December was a record month and 2008 was a record year for the Office of Inspector General (OIG), the law enforcement agency tasked with pursuing fraud and criminal activity in TennCare and preserving the integrity of the expanded Medicaid program.
“We are very serious about our duty to eliminate fraud in TennCare and to see that justice is served for people committing these crimes,” Inspector General Deborah Y. Faulkner said. “We pursue a lot of prescription drug fraud cases but we have also worked many cases where people try to hide their household income to get public-financed health care services.”
By the last week of December, the OIG had made 35 arrests for the month, including 20 who were arrested in Smith County on December 10 for prescription drug fraud involving pain medication obtained through TennCare with the intention to sell all or part of the prescription.
Throughout 2008, the OIG also logged a record year with 262 arrests bringing to the total number of individuals arrested for TennCare fraud in four years to 867. Faulkner said one of the most effective new tools the OIG special agents have is the “doctor shopping” law passed by the General Assembly and signed by the Governor in 2007.
“Once the ‘doctor shopping’ law was signed, we worked hard to get this information to pharmacists, medical providers and local police that this is now a crime that we can pursue,” Faulkner said. “Those cases routinely involve painkillers, with the drugs of choice being Oxycontin, Oxycodone, Hydrocodone, Percocet and even Morphine.”
Examples of OIG cases in 2008 include:
All the year’s TennCare fraud arrests and details of the crimes, along with photos, can be viewed online at http://tennessee.gov/finance/newsrel/newsroom.html#OIG.
The OIG, which is separate from TennCare, was created by Governor Bredesen and began full operation in February 2005 and has investigated cases leading to over $2.6 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $159 million for the TennCare program, according to latest figures.
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.tncarefraud.tennessee.gov and follow the prompts that read "Report TennCare Fraud."