Fayette County Man is Charged with TennCare Fraud

Tuesday, July 31, 2012 | 11:26 am

NASHVILLE – A Fayette County man is charged with using his son’s TennCare benefits to pay for prescriptions at a pharmacy in Somerville, Tennessee.

The Office of Inspector General (OIG) and the Fayette County Sheriff's Department today announced the arrest of Marlon Hester, Sr., 39, of Somerville.   A Fayette County Grand Jury accuses him of using his son’s TennCare benefits over a course of two months to pay for prescription medications for himself.

“Providing healthcare coverage for certain children who don’t have it has been a priority in Tennessee, but those benefits can’t be used by adults who are not on TennCare,” Inspector General Deborah Faulkner said. “TennCare is important for people who qualify – especially children – so we take this crime very seriously.”

Fraudulently obtaining TennCare medical benefits is a Class E felony that carries a maximum penalty of two years in prison. District Attorney General D. Michael Dunavant will prosecute.

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 1,700 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."