Rutherford Healthcare Workers Face Over 70 Drug Charges, Including TennCare Fraud

NASHVILLE – A nurse practitioner and two female employees of a LaVergne Medical Clinic have been charged with more than 70 offenses relating to prescription drugs, including TennCare fraud.

The Office of Inspector General (OIG) along with Detective Jeremy Weaver of the Rutherford County Sheriff’s Narcotics Office, as well as the US Drug Enforcement Agency (DEA) and the Tennessee Bureau of Investigation (TBI) launched an investigation in January 2009 when the OIG began receiving tips pertaining to fraudulent prescriptions being written.

“We see individual cases of TennCare fraud on a weekly basis, but it’s particularly troubling when trusted professionals are involved in perpetrating this activity,” Inspector General Deborah Y. Faulkner said. 

One suspect, 38-year old Stacy Rayfield of Coffee County has been indicted on 40 counts of prescription fraud and eight counts of TennCare fraud.

“After a year long investigation, we have found that Stacy Rayfield, a nurse practitioner, is at the center of this case,” Rutherford County Detective Jeremy Weaver said. “It was Ms. Rayfield’s DEA prescription number was used in the crimes.

“We believe Rayfield wrote prescriptions for other employees without seeing them as patients, and provided prescriptions for other individuals to the employees.”

Two other people are charged in connection with obtaining controlled substances by fraud:

• Nicole Avery, 21, of Rutherford County, charged with six counts of prescription fraud and two counts of TennCare fraud.  Avery is accused of fraudulently obtaining the painkiller Lortab, and Phentermine, a stimulant used mainly for weight loss, using TennCare to pay for them.  Avery’s bond has been set at $10,000.
• Mallory Waldon, 23, of Rutherford County, is charged with 19 counts of prescription fraud and three counts of TennCare fraud.  Waldon used TennCare to fraudulently obtain the painkiller Lortab on three separate occasions.  Waldon is currently in federal custody in Oklahoma on bank robbery charges, where she was served with the indictment.  Waldon’s bond will be set at $20,000 upon being returned to Tennessee.

 

In addition, a search is on for a fourth fellow employee, Tericka Jordan, who will be charged with 12 counts related to the case.  Upon capture, her bond will be set at $20,000.

This case began after an internal audit by the clinic’s manager found about 115 names of non-patients for whom prescriptions were filled between January 2008 and January 2009.  About 40 of those names were TennCare patients.

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison, and obtaining a controlled substance by fraud is a Class D felony, punishable by two to four years in prison per charge. District Attorney General William C. Whitesell, Jr. is prosecuting.

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 1,100 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."