TennCare "Doctor Shopping" Arrest in Cocke County

NASHVILLE – A Cocke County woman has been indicted for TennCare fraud involving “doctor shopping,” or using TennCare 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 Cocke County Sheriff’s Office today announced the arrest of Melissa A. Cagle, 28, of Newport. Cagle is charged with one count of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”

Cagle is accused of not telling her doctor that she had seen other physicians within a 30-day period and received prescriptions for the strong painkiller Hydrocodone with Codeine.  The physician office visits were paid for by TennCare.

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years in prison. District Attorney General James B. Dunn 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."