Wilson County Pair Charged with TennCare Fraud

NASHVILLE - Two people are charged in grand jury indictments in Wilson County for selling prescription drugs paid for by TennCare.

The Office of Inspector General (OIG) today announced the arrests of Rachel L. Mabe, 38, and Danny W. Caldwell, 48, both of Alexandria. The arrests are the result of a joint investigation with Sheriffs’ officers in Dekalb and Wilson counties.  Both are accused of fraudulently obtaining prescription drugs using TennCare benefits.

Mabe is accused of obtaining the painkiller Morphine Sulfate by using TennCare, then selling a portion of the pills.  Caldwell is charged after using TennCare pay for a prescription of the painkiller Hydrocodone, then selling a portion to an undercover agent.

“Not only did these individuals use TennCare to pay for the prescription that they ultimately sold, but they also used it to pay for their transportation to pick up their medication,” Inspector General Deborah Y. Faulkner said. “Enrollees who participate in selling drugs paid for by TennCare – and those who buy them – should understand this is a serious crime we intend to pursue every angle of it.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison. Acting District Attorney General Tom P. Thompson 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 1,230 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."