Kentucky Woman to Repay TennCare

NASHVILLE, Tenn. – A Kentucky woman must repay Tennessee for healthcare insurance benefits received while she was enrolled in TennCare, but not eligible for the state’s healthcare insurance program.

The Office of Inspector General (OIG) today announced a plea agreement involving Angelia Gibbs, 47, of Danville, Kentucky, means that she must pay restitution to TennCare in the amount of $47,365.23. She also received five years of Judicial Diversion in the case, which means that after the probation period, the charge will be expunged from her record. Gibbs was accused of fraudulently claiming that she lived in Tennessee and that she had dependent children, all in order to appear eligible for TennCare. District Attorney General Tom P. Thompson prosecuted the case.

“TennCare fraud crosses all social, economic and professional lines,” Inspector General Manny Tyndall said. “People committing TennCare fraud are taking something they’re not entitled to, and the chances of getting caught have increased substantially.” 

Until June 30, 2016, TennCare fraud was classified as a Class E felony carrying a sentence of up to two years in prison per charge.  As of July 1, 2016, TennCare fraud was changed to a Class D felony punishable by up to four years in prison.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to more than $3 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures. To date, 2,797 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 visit the website and follow the prompts that read “Report TennCare Fraud.”