Davidson County Woman Charged with TennCare "Doctor Shopping"
Tuesday, October 21, 2008 | 10:44am
NASHVILLE – A Davidson County woman has been indicted for TennCare fraud involving “doctor shopping,” or using TennCare benefits to go to multiple doctors in a short time period to obtain controlled substances.
The Office of Inspector General (OIG) with the assistance of the Metropolitan Nashville Police Department, today announced the arrest of Mary Elizabeth Duke, who is also known as Mary E. Schutt, 31, of Nashville.
She is charged with seven counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping” and eight counts of obtaining a controlled substance by fraud. The charges relate to receiving prescriptions for the painkillers Oxycodone and Hydrocodone, failing to disclose to her doctor that she had seen other physicians within a 30-day period to obtain additional prescriptions for the addictive painkillers. In all instances, TennCare paid for the physician’s office visit or the prescription drugs.
"We’ve received outstanding response from physicians and other providers across the state in our efforts to crack down on people who ‘doctor shop’ in the TennCare program,” Inspector General Deborah Faulkner said. “We are fortunate to have this tool in Tennessee to protect the integrity of TennCare.”
TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison on each charge. District Attorney Victor S. Johnson, III will be prosecuting this case.
The OIG, a law enforcement agency separate from TennCare, began full operation in February 2005 and has worked cases leading to the arrest of 810 individuals for TennCare fraud, with nearly $1 million paid in restitution to TennCare, and total estimated cost avoidance in TennCare of over $122 million, according to latest figures.
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.tncarefraud.tennessee.gov and follow the prompts that read "Report TennCare Fraud."