Jackson County Man Ordered to Repay TennCare

NASHVILLE  – A Jackson County man is ordered to repay $7,500 to the State of Tennessee for services he received while he was a member of TennCare, after he was accused of misrepresenting himself in order to obtain TennCare.  

The Office of Inspector General (OIG) today announced that Jefferson B. Emerton, 38, of Gainesboro, received two years pre-trial diversion for TennCare fraud and theft of services. During the two years, he can not apply for or receive TennCare benefits, and he will repay TennCare $7,500 in restitution. 

Emerton was indicted in August 2008 and charged with TennCare fraud and theft of services for claiming he had a dependent in his household when he did not, and that disclosure would have made him ineligible for the program.

“Citizens are tired of seeing people in TennCare when they’re not actually eligible for the program, and the tips we receive from the public have helped us tremendously with these cases,” Inspector General Deborah Faulkner said.  “We follow up on every tip – quickly – regardless of whether the information came from an anonymous or named source.”

District Attorney General Tom P. Thompson prosecuted the 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 1,100 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."