HOUSTON, CARROLL COUNTY ARRESTS FOR TENNCARE FRAUD

NASHVILLE - Three people from counties in West Tennessee are charged today with TennCare fraud.

The Office of Inspector General (OIG) today announced that Carla Caksackkar, 48, and Jeffery Mathis, 36, both of Houston County were accused of selling prescription painkillers to undercover officers with the Houston County Sheriff’s Office. The drugs were paid for through the TennCare program. Caksackkar sold her prescription for Oxycodone and Mathis sold his prescription for a Codeine drug.

In an unrelated case in nearby Carroll County, Bert Wayne Bailey, 54, of Cedar Grove, is charged with two counts of fraudulently obtaining controlled substances by “doctor shopping.” Bailey failed to disclose to his doctors that he had seen other physicians within a 30-day period and received similar prescriptions for the painkiller Hydrocodone. All the physician office visits were paid for by TennCare.

“We’re working with the law enforcement community – from U.S. marshals to local police officers – to work closely to identify, investigate, and prosecute any one who tries to take advantage of TennCare,” Inspector General Deborah Y. Faulkner said.

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison. District Attorney General Dan M. Alsobrooks will be prosecuting the Houston cases; District Attorney General Hansel McCadams will be prosecuting the case in Carroll County.

The OIG, a law enforcement agency separate from TennCare, began full operation in February 2005 and has worked cases leading to the arrest of over 760 individuals for TennCare fraud, with nearly $1 million paid in restitution to TennCare, and total estimated cost avoidance in TennCare of over $122 million, 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."