TennCare Fraud Convictions Lead to Repayment for Services

NASHVILLE, Tenn. – Three people convicted of TennCare fraud will make restitution to the state totaling over $10,000.

The Office of Inspector General (OIG) today announced the convictions and sentencing of people in Shelby, White, and Knox Counties.

“These cases represent the constant effort we are making to win the battle against TennCare fraud.”  Inspector General Manny Tyndall said.  “People who do this can face jail time, making restitution as well as supervised probation, along with fines and court costs.”

Tonya Gist, 34, of Sparta, must pay the state $6,041.50 after pleading guilty to TennCare fraud and theft of services in White County. She was arrested in January and charged with fraudulently claiming that she was pregnant in order to be eligible for TennCare benefits. She is also on supervised probation for four years. District Attorney Bryant C. Dunaway prosecuted the case.

Mary E. Wilder, 37, of Knoxville is ordered to pay the state $4,408.60 in restitution after pleading guilty in Knox County to six counts of TennCare fraud.  She was arrested in February when she was charged with using TennCare to obtain controlled substances by doctor shopping. She was also placed on supervised probation for two years and fined $1,000.  District Attorney General Charme P. Allen prosecuted the case.

Shalanda Grant, 33, of Memphis was ordered to pay restitution in the amount of $1,527.00 after pleading guilty in Shelby County to TennCare fraud and theft of services. She was arrested April 20 when she was charged with doctor shopping for drugs, using TennCare as payment.  She will be on supervised probation for two years.  District Attorney General Amy T. Weirich prosecuted the case.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3 million being repaid to TennCare, with a total estimated cost avoidance of over $163.6 million for TennCare, according to latest figures. To date, 2,355 people have been charged with TennCare fraud.

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 Office of Inspector General and follow the prompts that read "Report TennCare Fraud."