CUMBERLAND CO. WOMAN PLEADS GUILTY TO TENNCARE FRAUDORDERED TO PAY $6,821 IN RESTITUTIONNASHVILLE – A Cumberland County woman has pleaded guilty to TennCare fraud and must repay TennCare for services they used while they were on the program. The Office of Inspector General today announced that Susan Tabor, 58, pleaded guilty to one count of TennCare fraud. She and her husband received TennCare medical and pharmacy benefits totaling $6,821.85 that they must repay to TennCare. Officials say Tabor had access to healthcare insurance through her employer, but intentionally withheld that information from TennCare. Governor Phil Bredesen created the Office of Inspector General, one of the first units of its kind in the nation, in 2004. Since it became operational in February 2005, 228 people have been charged with TennCare fraud, leading to 57 convictions for TennCare fraud and 14 cases resolved. “We are hoping to make it clear that anyone who fails to report insurance benefits from an employer will be indicted and arrested for TennCare fraud,” Inspector General Deborah Faulkner said. “We are actively investigating TennCare members who are not eligible because they have healthcare insurance in their workplace, and we are always matching employer databases with the TennCare rolls.” Tabor pleaded guilty to a Class E felony charge for TennCare fraud, and in addition to paying restitution and a $500 fine, she received a two year suspended sentence with two years’ probation and has agreed not to reapply for TennCare during her probationary period. Anyone can report suspected TennCare fraud by calling 1-800-433-3982 toll-free from anywhere in Tennessee, or log on to www.tennessee.gov/tenncare and follow the prompts that read “Report Fraud Now.”
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