Twin Sisters in Rutherford County Charged with TennCare "Doctor Shopping"

NASHVILLE – Twin sisters from Rutherford County are each 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 Rutherford County Sheriff’s Office today announced the arrests of Bridget and Nicole Heath, both 25, of Smyrna. They’re each charged with four counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.”

Indictments accuse them of failing to disclose to their doctor that they had seen other physicians within a 30-day period and received a prescription for the strong painkiller Lortab, with the physician office visits being paid for by TennCare.  Bridget was also charged with one count of identity theft for allegedly identifying herself as her sister at a physician’s office to obtain medical services.

"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 William Whitesell, Jr. will be prosecuting these cases.

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."