HAMBLEN CO. COUPLE ORDERED TO REPAY TENNCARE
RECEIVED OVER $10,000 IN BENEFITS THEY WERE NOT ELIGIBLE FOR
NASHVILLE A husband and wife from Hamblen County have agreed to repay TennCare for pharmacy and medical benefits they received from the state although they were not eligible for the program.
The Office of Inspector General today announced that Joe Gibson, 47, and his 46-year old wife Laura received pre-trial diversion, allowing them to forego prosecution on certain conditions, including paying $10,699.16 restitution to 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.
In addition to restitution, the Gibsons must each perform 225 hours of community service work over the next 18 months and must each pay $35 a month to the Department of Correction (TDOC) for probation supervision.
A Hamblen County Grand Jury accused the Gibsons in October 2005 of intentionally failing to notify TennCare of changes that would have made them ineligible for the program. Agents report Joe Gibson had access to, but turned down insurance from his employer, obtaining medical and pharmacy benefits through TennCare instead. District Attorney C. Berkeley Bell prosecuted their case. Each of the Gibsons could have faced up to eight years in prison for the Class D felony.
We will prosecute both husband and wife when an investigation points to both individuals, no matter who completes the TennCare application, Inspector General Deborah Y. Faulkner said. 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.”