Shelby Co. Woman Charged with TennCare Fraud

NASHVILLE, Tenn. – A Shelby County woman is charged with TennCare fraud and theft of services in an indictment accusing her of falsely reporting her income and marital status in order to enroll herself and her daughter for TennCare benefits.  

The Office of Inspector General (OIG) in a joint effort with the Shelby County Sheriff’s Office today announced the arrest of 39-year old Tisa R. Thomas of Memphis. She’s charged with TennCare fraud, a class D felony and theft of services over $10,000 but under $60,000, a class C felony.

Investigators say Thomas was employed and over the income threshold to legally enroll herself and her daughter in TennCare, which resulted in TennCare paying $22,576.47 on their behalf.

“If an individual is not qualified for TennCare benefits, they are not entitled to have TennCare pay for their medical bills and pharmacy claims,” Inspector General Kim Harmon said. “The Office of Inspector General strives to protect our taxpayers’ hard earned money and ensure that those who choose to commit fraud will be sought out and prosecuted.”

If convicted of the charges, Thomas could face penalties of up to 27 years in prison. The case is being prosecuted by District Attorney General Amy T. Weirich of Shelby County.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated over 5,760 criminal cases leading to more than $10.8 million ordered in restitution to TennCare.  This has helped lead to a total estimated cost avoidance of more than $163.6 million for TennCare, according to the latest figures. To date, 3,142 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 or by logging on to www.tn.gov/oig/ and following the prompts that read “Report TennCare Fraud.”