Greene County Woman Charged with TennCare "Doctor Shopping"

NASHVILLE – A Greene County woman is charged with TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.

The Office of Inspector General (OIG) with the assistance of the Greene County Sheriff’s department today announced the arrest of Alicia D. Jones, 27, of Greeneville.   She is charged with two counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.”  

Jones failed to disclose to her doctor that she had seen another physician within a 30-day period and received a prescription for the strong painkiller Hydrocodone with the physician office visits being paid for by TennCare.

"The ‘doctor shopping’ law passed by the Legislature is a valuable tool in cracking down on people who are abusing the program,” Inspector General Deborah Faulkner said. “Physicians across the state have applauded this new law and our efforts to stop people from doing this and are helping us develop these cases.”

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison.  District Attorney General C. Berkeley Bell will be prosecuting this 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 1,240 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."