Williamson County Couple Charged with TennCare Fraud

NASHVILLE - A Williamson County couple is charged with TennCare fraud, after it was discovered their children were on TennCare, but not eligible for the program.

The Office of Inspector General (OIG) today announced the arrest of Jose Valadez, 48, and his wife, 37-year old Maria Valadez of Franklin.  The arrest was assisted by the Williamson County Sheriff’s Office.

They are each charged with TennCare fraud and theft of services for fraudulently obtaining TennCare medical assistance benefits for their children by underreporting their income on a TennCare medical assistance application.

“We will prosecute both husband and wife when an investigation points to both individuals gaining benefits they are not eligible for,” Inspector General Deborah Y. Faulkner said.  “We intend to make sure everyone on TennCare is eligible for TennCare.”

If convicted, the Valadez’s could be sentenced to up to four years on the Class D felony of theft of services, and an additional two years on the Class E felony of fraudulently obtaining TennCare services.  Williamson County District Attorney General Kim Helper will prosecute.

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 1,230 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."