Office of Inspector General
The mission of the Tennessee Office of Inspector General is to identify, investigate, and prosecute persons who commit fraud against TennCare.
Under the TennCare Fraud and Abuse Reform Act, Tennessee Code Annotated 71-5-2505 and subsequent legislation, the OIG is authorized to:
- investigate civil and criminal fraud and abuse of the TennCare programs, or any other violations of state criminal law related to the operation of TennCare, including allegations of fraud or abuse involving TennCare managed care organizations (MCOs);
- cooperate with the Medicaid Fraud Control Unit at the Tennessee Bureau of Investigation and refer instances of provider fraud and abuse to that unit;
- furnish the public with information about the fraud and abuse laws pertaining to TennCare;
- provide legal assistance to the Attorney General and the District Attorneys General in initiating and handling proceedings in appropriate TennCare fraud and abuse cases, including criminal prosecutions, civil recoveries, and forfeitures;
- employ qualified law enforcement officers with authority to enforce the fraud provisions;
- pay cash rewards to citizens who provide information regarding TennCare fraud which leads to a criminal conviction;
- subpoena witnesses and records in connection with any investigation into TennCare fraud or abuse.