North Carolina Woman Charged with TennCare Fraud

NASHVILLE, Tenn. – A North Carolina woman is charged with TennCare fraud and theft of services for misrepresenting her circumstances in order to qualify for the state’s healthcare insurance program.

The Office of Inspector General (OIG) today announced the arrest of Julie Carpenter of Mitchell County, North Carolina. The arrest is the result of a joint effort with the Mitchell County Sheriff’s Office of North Carolina.  She was transported to the sheriff’s office of Johnson County, TN where she is currently being housed.  Carpenter is charged with one count of obtaining benefits through TennCare despite not qualifying for the program and one count of theft of services over $10,000.

Investigators say Carpenter reported that she had custody of her son when in fact the paternal grandparents of the child had court-ordered custody elsewhere.  Additionally, it was discovered that Ms. Carpenter was not a resident of Tennessee and was in fact residing in Mitchell County, North Carolina.  Carpenter continued to report this status to TennCare over a period of approximately a year and a half.  Had Carpenter properly reported her household composition or out of state residency, she would have immediately been disqualified from TennCare.     

“The TennCare program is designed to provide benefits for the residents of Tennessee who rightfully qualify,” Inspector Kim Harmon said.  “The Office of Inspector General has demonstrated a proven commitment through our diligent investigation process to ensure that our taxpayer’s money is being used properly.  It is our duty to ensure that those who choose to commit fraud will be sought out and prosecuted.”

If convicted Ms. Carpenter could face penalties of up to a maximum of 24 years in prison for the charges of TennCare fraud and theft of services under $10,000, both of which are Class D felonies. The case is being prosecuted by District Attorney Ken Baldwin of Johnson City, TN.

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, 3,122 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/oig/ and follow the prompts that read “Report TennCare Fraud.”