Sumner County Woman Charged with TennCare Fraud

NASHVILLE – A Sumner County woman is charged with attempting to fill an altered prescription and use TennCare to pay for the drugs.

The Office of Inspector General (OIG) along with the Sumner County Sheriff’s Office today announced the arrest of Kesha L. Sheffield, 30, of Hendersonville. 

Sheffield was charged with one count of attempting to obtain TennCare benefits by fraud.  The charges say she altered a prescription from a local physician for the painkiller Percocet, increasing the number of pills she was prescribed.  The increased number of doses alerted the pharmacist, who contacted authorities. Sheffield has also been charged with drug fraud and criminal simulation.

“Local law enforcement officers across the state have welcomed the chance to contact us, so we can prosecute people committing crimes against TennCare,” Inspector General Deborah Y. Faulkner said.  “We are continually working with local police – as well as providers - to make sure they know what to do when they suspect TennCare fraud.”

Illegally obtaining TennCare medical benefits is a Class E felony that carries a maximum penalty of two years in prison.  District Attorney General Lawrence R. Whitley will prosecute 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."