Knox County Woman Charged with TennCare Doctor Shopping

Wednesday, September 11, 2013 | 07:05am

NASHVILLE, TN - A Knox County woman is charged in an indictment with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances.

The Office of Inspector General (OIG), with assistance from the Knox County Sheriff’s Office, today announced the arrest of Deloris McClure, 42, of Knoxville.  She is charged with nine counts of fraudulently using TennCare to obtain controlled substances by doctor shopping.   In addition, McClure was charged with 14 counts of obtaining a controlled substance by fraud. 

TennCare fraud involving doctor shopping is a Class E felony carrying a sentence of up to two years per charge in prison.  Obtaining a controlled substance by fraud is a Class D felony that carries a sentence of up to four years in prison per charge.  District Attorney General Randall Nichols is prosecuting.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $173 million for the TennCare program, according to latest figures.  To date, over 1,900 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."

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