Shelby County Woman Charged with TennCare "Doctor Shopping"

Monday, September 10, 2012 | 12:36 pm

NASHVILLE – A Shelby County woman is charged with TennCare fraud involving “doctor shopping,” or using TennCare public healthcare insurance to go to multiple doctors to obtain prescription drugs.

The Office of Inspector General (OIG) today announced the arrest of Sandra Jones, 43, of Memphis.   She is charged with “doctor shopping” for controlled substances, using TennCare as payment.

“Tennessee has targeted TennCare fraud for elimination, especially in the area of prescription drugs,” Inspector General Deborah Y. Faulkner said.  “Many times, these drugs are used for resale, and that’s a threat to communities across the state.”

TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison.  District Attorney General Amy P. Weirich is prosecuting.

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.