Ohio Woman Charged 3rd Time with TennCare Fraud

NASHVILLE, Tenn. – An Ohio woman is charged for the third time with TennCare fraud involving prescription drugs.

The Office of Inspector General (OIG) today announced the arrest of Lori D. Fiss, 47, of Hamilton County, Ohio.

A Davidson County indictment charges her with nine counts of fraudulently obtaining a controlled substance by doctor shopping, which involves using TennCare to visit multiple doctors in a short time period to obtain prescription drugs. In this case, the drugs involved were the painkillers Hydrocodone, Oxycodone and Tramadol. In addition, Fiss is charged with ten counts of obtaining a controlled substance by fraud.

Fiss was being held in the Maury County Jail on unrelated charges and upon release she was transported to Davidson County to face the current charges.

Fiss was first arrested in December 2017, after being on the run from law enforcement for eight months. She was discovered living in Ohio and was returned to Williamson County where she was charged with five counts of TennCare doctor shopping, seven counts of prescription drug fraud and two counts of identity theft. The drugs involved in that arrest were the painkillers Oxycodone and Hydrocodone.

She was released from jail in April of this year, and was transported to Maury County where she faced her second set of charges for TennCare doctor shopping involving Hydrocodone, Oxycodone and Tramadol. During the time the crime occurred, she was a resident of Williamson County.

“Eliminating the abuse of TennCare benefits, especially to obtain pain medications, is one of our main priorities,” Inspector General Kim Harmon said. “Local police, providers and the healthcare community are with us in our effort to weed out this problem within the TennCare program.”

District Attorney General Glenn R. Funk is prosecuting. TennCare fraud is 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, 3,002 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 www.tn.gov/tnoig/ and follow the prompts that read “Report TennCare Fraud.”