Maury County Man Charged with TennCare "Doctor Shopping" for Drugs
Thursday, October 30, 2008 | 07:48am
NASHVILLE - A Maury County man has been indicted in Davidson County 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 Maury County Sheriff’s office today announced the arrest of Michael R. Averett, 51, of Columbia.
Averett is charged with two counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.” An indictment says he received prescriptions for the same or similar controlled substance and failed to disclose to his doctor that he had seen other physicians within a 30-day period to obtain additional prescriptions for the same or similar controlled substance. Averett used TennCare to pay for either the clinical visit or for payment of the controlled substances.
"We have had an outstanding response from physicians and other medical providers across the state in our efforts to crack down on people who ‘doctor shop’ in the TennCare program,” Inspector General Deborah Faulkner said. “Tennesseans are fortunate to have this tool we can use against fraud in our public health insurance program.”
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 General Victor S. Johnson, III is prosecuting.
The OIG, a law enforcement agency separate from TennCare, began full operation in February 2005 and has worked cases leading to the arrest of over 815 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."