McNairy Co. Man Charged with TennCare Fraud

Friday, June 12, 2020 | 02:40pm
Douglas Pickens

NASHVILLE, Tenn. – A McNairy County man is charged with TennCare fraud and theft of services for allegedly misrepresenting his household in order to enroll in TennCare, the state’s healthcare insurance program.  

The Office of Inspector General (OIG), in a joint effort with the McNairy County Sheriff’s Office, today announced that 42-year old Douglas Pickens is charged with TennCare fraud and theft of services over $10,000 but under $60,000.

Pickens allegedly claimed to have custody of his children in order to obtain TennCare benefits for himself and the children. Investigators say they obtained evidence the children were not living with him, which disqualifies him for TennCare. As a result, TennCare paid approximately $11,000 in fees and claims on behalf of Pickens and his children. 

“Providing false information in order to receive TennCare depletes resources intended for those who rightfully qualify,” Inspector General Kim Harmon said. “We greatly appreciate our community partners who work alongside OIG to preserve TennCare benefits.”

The theft of services charge is a class C felony and the TennCare fraud charge is a class D felony. If convicted, Pickens could face penalties of up to 27 years in prison. The case is being prosecuted by District Attorney General Mark E. Davidson of McNairy 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, 3,161 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.”