Hickman County Man Charged with TennCare Drug Fraud

NASHVILLE – A Hickman County man is charged for the second time with TennCare prescription drug fraud.

The Office of Inspector General (OIG) today announced the arrest Mark Christopher Setzer, 32, of Nunnelly. The arrest was assisted by the Hickman County Sheriff’s Office and the 21st Judicial District Drug Task Force.

Setzer is accused of presenting a forged prescription for Suboxone, a drug used to treat addiction to morphine or heroin, at a pharmacy in Centerville.  The prescription was in the name of a family member and TennCare paid for it.  Setzer faces one count each of TennCare fraud, obtaining a controlled substance by fraud, and forgery.

Setzer was previously arrested last month, when he was accused of presenting altered prescriptions for the painkillers Hydrocodone and Oxycodone to a pharmacy in Columbia, using a family member’s TennCare card to pay for the prescriptions.   He’s facing one count of TennCare fraud and two counts of obtaining a controlled substance by fraud in that case.

"The OIG’s continued mission is to end fraud and abuse of TennCare, and make sure that doctors and pharmacies know some of the ways people try to get fraudulent prescriptions filled,” Inspector General Deborah Faulkner said. "We want people to think twice before attempting TennCare fraud – because there is a price to pay when they are caught."

TennCare fraud and forgery are Class E felonies carrying a sentence of up to two years in prison. Obtaining controlled substances by fraud is a Class D felony that carries a sentence of up to four years in prison. District Attorney General Kim R. Helper 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."