Health Care News NewsTracker

TennCare Fraud Perp Gets Prison

A mere 12 days into the New Year, Tennessee has already seen plenty of TennCare fraud news, from “doctor shopping” to one case in which a health worker was sentenced to eight years in prison.

  • In that case, a home health care worker was fired from his job, but managed to get his wife hired instead though he continued to perform the work, the Commercial Appeal reported. Jimmie Lang Jr. pleaded guilty and was sentenced to eight years in prison, and his employer, Home Care Solutions, was ordered to repay TennCare the $90,000 it took under fraudulent circumstances.
  • An Overton County woman has pleaded guilty to TennCare fraud. Her prison sentence has been suspended, contingent on her repaying the state almost $27,000, in addition to paying a $5,000 fine and court costs, according to the Overton County News. Leslie A. Christensen, of Livingston, was targeted as part of a wider probe of Clark’s Pharmacy, in Livingston, that implicated pharmacist Malcolm D. Clark and 22 TennCare enrollees.
  • A Monterey TennCare enrollee was arrested after allegedly “doctor shopping,” going from one physician to another with the aim of amassing painkillers and other controlled substances, the Herald-Citizen reported. Anna Ledford, 53, used TennCare to pay for the pills and doctor visits and has been charged with TennCare fraud. Knoxville resident Michelle Hawkins, 22, and Bradley Allen Price, 34, of Harriman, were also charged with TennCare fraud stemming from “doctor shopping,” according to the state Office of Inspector General.
  • A Rockwood man used TennCare to obtain the painkiller Oxycodone, with the intent to resell at least part of the drugs, the Office of Inspector General announced. Robert Wayne Edwards, 52, has been charged with TennCare fraud.
  • Painkillers were also involved in a Rutherford County case that has implicated staff at La Vergne Medical Clinic. Mallary Waldon, 24, of Smyrna, and three others at the clinic allegedly obtained prescriptions for painkillers and other drugs, which were paid for with TennCare, the Murfreesboro Post reported. Waldon has been charged with multiple counts of prescription fraud and TennCare fraud.

TennCare is the state’s version of Medicaid, the federal health insurance program for the poor.

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