Davidson Co. Woman Charged in Wilson Co. for TennCare "Doctor Shopping"

Wednesday, October 22, 2008 | 7:34am

NASHVILLE – A Nashville woman has been indicted in Wilson County for “doctor shopping,” or going to multiple doctors in a short period of time to obtain similar prescriptions for controlled substances.

The Office of Inspector General (OIG) today announced the arrest of 32-year old Lesley M. Carter, who was charged with two counts of fraudulently obtaining controlled substances by “doctor shopping.” Carter failed to disclose to her doctors that she had seen other physicians within a 30-day period and received the same or similar prescriptions for the painkiller Hydrocodone, using TennCare to pay for the physician office visits.
"The fraudulent misuse of TennCare benefits is a serious issue but Tennessee is out front in waging war on this crime," Inspector General Deborah Y. Faulkner said. “Health care providers and their employees have become very good at spotting these cases and they are committed to assisting us with stopping TennCare fraud.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison. District Attorney General Tom P. Thompson is prosecuting.
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 810 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."

TennCare Fraud