Carroll County Man Charged for 2nd Time with TennCare "Doctor Shopping" for Drugs

NASHVILLE – A Carroll County man has been charged for the second time with “doctor shopping,” or going to multiple doctors in a short period to obtain the same or similar controlled substances, using TennCare to pay for it.

The Office of Inspector General (OIG) today announced the arrest of 54-year old Bert Wayne Bailey, Jr., who was indicted by a Gibson County Grand Jury on three counts of fraudulently obtaining a controlled substance and allowing TennCare to pay for it.  Bailey failed to disclose to his doctor that he had seen another physician within a 30-day period and received similar prescriptions for the painkillers Hydrocodone and Oxycodone. TennCare paid for the prescriptions.

Bailey was previously arrested two months ago - on September 4th - after an indictment accused him two counts of “doctor shopping” related to the same addictive painkiller, Hydrocodone.

“Certain prescription drugs are classified as controlled substances because they have a dangerous potential for abuse and addiction,” Inspector General Deborah Faulkner said. “TennCare pays for such medications when prescribed under the direction and supervision of a physician, but we’re committed to pursuing those cases involving fraud and abuse especially when these classifications of dangerous drugs are involved.”

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison.  District Attorney General Garry Brown 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 820 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."