Overton County Man Convicted of TennCare Fraud

 NASHVILLE – An Overton County man charged with TennCare fraud has been ordered to serve a total of four years in a state prison.

The Office of Inspector General (OIG) today announced the conviction of Michael Fulton, 24, of Pall Mall.  Fulton pleaded guilty to two counts of TennCare fraud, receiving two consecutive two-year sentences for a total of four years in prison, and was also ordered to pay TennCare restitution of over $1,600.

Fulton was among 20 suspects rounded up by the OIG in October 2007 during an undercover operation involving an Overton County pharmacy where people could easily get prescriptions filled without questions. 

The investigation showed that prescriptions for strong pain medications were filled even when it was obvious prescription quantities had been changed, and some prescriptions for morphine were on what police described as plain copy paper, without even a doctor’s signature.  The drugs were all paid for by TennCare.  The pharmacist, Malcolm Clark of Clark’s Pharmacy, was also charged at the time with more than a hundred counts related to illegally dispensing controlled substances. 

In Fulton’s case, he had presented forged prescriptions for painkillers, antibiotics and anti-anxiety medications.

“The illegal trafficking of drugs is a problem across the state, and we simply will not tolerate it in the TennCare program,” Inspector General Deborah Faulkner said.

District Attorney General Randal York along with Assistant District Attorney Owen Burnett prosecuted this case.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $2.6 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $159 million for the TennCare program, 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."