TennCare Fraud Covered by Nashville City Paper

TennCare Fraud Covered by Nashville City Paper

News and Commentary | Breaking News | Fraud Cases | Medicaid Fraud Cases

According to the article by Judith R. Tackett, TennCare is increasing their focus on beneficiary fraud through their new Office of Inspector General:

“Faulkner, who was appointed by Gov. Phil Bredesen in July 2004 to establish the state’s Office of Inspector General, said Tennessee is ahead of the game when it comes to fighting TennCare fraud. Her office targets TennCare recipients committing fraud while the TBI concentrates on provider fraud.

“Trying to call around to other states across the United States, we‘ve not really found anything that looks like what we’re doing here,” she said.

The number of arrests is up significantly, from five last year to more than 110 so far this year.

Since Jan. 1, Faulkner said, her office has received 60,386 complaints of TennCare fraud through phone calls, the office’s Web site and by other means.

Of those 60,386 tips, 9,024 are cases that have the potential for fraud. That number was further distilled down to 2,487 drug cases. Of those, the Office of Investigator General is currently investigating 350 cases.

Besides drug cases, Faulkner’s office is also looking at income cases where people have underreported their income, insurance cases where people have access to other insurance, and out-of-state cases where TennCare recipients actually live in another state.”