HAMILTON COUNTY MAN CONVICTED OF TENNCARE FRAUD

MUST REPAY $22,000 TO TENNCARE

NASHVILLE – A Hamilton County man accused of getting TennCare benefits for which he was not eligible must repay the state over $22,000 for medical services provided through TennCare.

The Office of Inspector General (OIG) today announced that 61 year-old Calvin Simmons of Chattanooga pleaded guilty to theft of services, a Class C felony. He received a three-year suspended sentence with six months probation and he must repay TennCare $22,278.82 for benefits paid on his behalf.

Simmons was charged after it was discovered he failed to report his employment and access to insurance to the Department of Human Services. Because he had access to healthcare insurance, he was no longer eligible for TennCare, but he continued to use TennCare to pay for medical services. The case was prosecuted by Assistant District Attorney Neal Pinkston.

“We hope this conviction sends a message that anyone who fails to report income or access to insurance will be charged with TennCare fraud and will be expected to repay TennCare for medical benefits,” Inspector General Deborah Y. Faulkner said. “People who have access to healthcare insurance are not eligible for TennCare – even if they turn down the insurance or don’t feel they can afford it.”

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.”