TennCare misuse alleged
by GREG KAYLOR, Banner Staff Writer
Jun 07, 2012 | 1159 views | 0 0 comments | 3 3 recommendations | email to a friend | print
Troy
Troy
slideshow
During the past few months, investigators have been busy cracking down on alleged TennCare misuse or fraud.

Doctor shopping is described as an individual illegally soliciting area medical or pain treatment centers to obtain multiples of prescription drugs, typically to resell the drugs for a profit.

According to the Office of the Inspector General, a Marion County man was the most recent area resident charged with “doctor shopping.”

“The Office of Inspector General, with the assistance of the Bradley County Sheriff’s Office, today announced the arrest of Randy W. Troy, 44, of Whitwell. He was charged with one count of fraudulently using TennCare to obtain a controlled substance by doctor shopping, or going to multiple doctors in a short period of time to obtain prescription drugs,” according to information from the OIG.

“When individuals misuse their TennCare benefits, it’s a serious issue the Office of Inspector General will not tolerate,” Inspector General Deborah Y. Faulkner said. “Anyone committing TennCare fraud will be investigated, prosecuted, and arrested by the OIG.”

Other recent TennCare Fraud allegations include Michelle Hicks, 24, of Bradley County who was accused of doctor shopping, as well as Melissa Faye Cronan, 45, who was charged with the same offense. Cronan listed her address as Old Fort, according to the OIG.

Lacey Rogers, 26, of Tunnel Hill, Ga., was charged by officials after she allegedly used TennCare, but was a resident of Georgia.

Clifford M. Guthrie, 29, was also recently charged with fraudulently obtaining narcotics, according to the OIG.

A grand jury indicted Guthrie on three counts of TennCare fraud for “doctor shopping,” and three counts of obtaining the painkiller Lortab, a brand version of hydrocodone, by fraud, according to the OIG. “Guthrie is accused of knowingly giving false information or withholding information in order to fraudulently obtain the drugs, using TennCare benefits to pay for both clinical visits and the Lortab prescriptions.

“TennCare fraud is a Class E felony carrying a sentence of up to two years in prison. District Attorney General Steven Bebb will be prosecuting this case. To date, over 1,600 people have been charged with TennCare fraud,” according to OIG officials.

Anyone knowing of TennCare misuse is urged to contact the OIG at 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.”