Hamilton County Woman Charged with TennCare Fraud
NASHVILLE – A Hamilton 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 prescriptions for a controlled substance.
The Office of Inspector General (OIG) with assistance from the Hamilton County Sheriff’s Department today announced the arrest of Deborah L. Reel, also known as Deborah L. Jones, 56, of Chattanooga. Reel is charged with two counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.”
The indictment accuses Reel of failing to disclose to her doctor that she had seen other physicians within a 30-day period and received a prescription for the strong painkiller Hydrocodone, with the physician office visits and prescription being paid for by TennCare.
"Physicians, pharmacists, law enforcement and communities were tired of watching people ‘doctor shop,’ and use TennCare to pay for the activity,” Inspector General Deborah Y. Faulkner said. “But the relatively new ‘doctor shopping’ law is helping us mount a real crackdown on people using TennCare this way.”
TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney General William Cox will be prosecuting this case.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $2.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $171 million for the TennCare program, according to latest figures. To date, over 1,240 people have been charged with TennCare fraud.
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.tn.gov/tnoig and follow the prompts that read "Report TennCare Fraud."