Six People Charged with TennCare Fraud in Gibson County Indictments

Tuesday, January 12, 2010 | 02:46 pm

NASHVILLE – Six people are charged with TennCare fraud in Gibson County, including a mother and daughter who were also charged with TennCare fraud last month.  The arrests are the result of a joint investigation led by the Office of Inspector General (OIG), Trenton, Dyer and Rutherford Police departments and the Gibson County Sheriff’s Office.

The six arrested are:

  • Kimberly Michelle Dallas, 22, and her mother Cheryl Lynn McGuire, 42, of Dyersburg, both charged in December of last year with prescription forgery in Dyer County.  This time, the Gibson County charges include one count of TennCare fraud and one count of obtaining a controlled substance by fraud against the daughter, Kimberly, for presenting an allegedly forged prescription for the painkiller Hydrocodone, using TennCare to pay for the prescription.  Her mother, Cheryl McGuire, is charged with one count of obtaining a controlled substance by fraud. 
  • Tonya C. Isbell Raybon, 36, of Rutherford, indicted on ten counts of TennCare fraud, forty-eight counts of obtaining a controlled substance by fraud, forty-six counts of forgery, and fifteen counts of identity theft.   The charges say that between February 2 and July 13 of last year, Raybon presented approximately 32 forged prescriptions written for herself and three other people for Schedule II and Schedule III controlled substances and used TennCare to pay for the prescriptions.  The drugs involved are the painkillers Hydrocodone, Oxycodone, and Percocet, along with the antibiotics Augmentin and Amoxicillin, and two drugs that contain Hydrocodone, Tussionex and CodiClear.  
  • Felicia B. Hughey, 24, of Dyer, indicted on two counts of TennCare fraud and three counts of obtaining a controlled substance by fraud.  She’s accused of presenting forged prescriptions for Hydrocodone using TennCare to pay for some of the drugs.  It’s her second arrest by the OIG, as she was arrested in December 2009 and charged with one felony count of obtaining a controlled substance by fraud.
  • Tina Sue Clifton, 31, of Dyer, charged with six counts of TennCare fraud and six counts of obtaining a controlled substance by fraud.  Clifton allegedly presented forged prescriptions for the painkillers Hydrocodone and Oxycodone as well as the antibiotic Amoxicillin – all paid for in part by TennCare.
  • Jeremy A. Kirby, 26, of Dyer, is charged with one count of TennCare fraud and two counts of obtaining a controlled substance by fraud.  Kirby allegedly presented a forged prescription for the painkiller Hydrocodone and used TennCare to pay for some of the prescriptions.

 

“We’re very grateful for the assistance we receive from local police as well as pharmacies and providers who all want to bring an end to the abuse of TennCare, especially in the area of prescription drugs,” Inspector General Deborah Faulkner said. “We’ll keep pursuing people who commit these crimes as many times as it takes until they understand we’re not tolerating this type of abuse of the TennCare program.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. Attempting to obtain a controlled substance by fraud and identity theft both are Class D felonies that carry a sentence of up to four years in prison per charge. District Attorney General Garry Brown is prosecuting.

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 1,100 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 http://tennessee.gov/tnoig/ and follow the prompts that read "Report TennCare Fraud."