Woman charged with TennCare Fraud for second time

120612 Amanda Adams

A Robertson County woman is charged for a second time with TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors to obtain controlled substances.

The Office of Inspector General (OIG), with the assistance of the Robertson and Davidson County Sheriff Offices, today announced the arrest of Amanda M. Adams, 27, of Springfield.  A Davidson County Grand Jury indictment accuses her of four counts of fraudulently using TennCare to obtain controlled substances by “doctor shopping.”  Adams failed to disclose to her doctor she had seen other physicians and received prescriptions for the pain medications Lortab, Oxycodone and Tylenol III, with the physician office visits and/or the prescriptions being paid for with TennCare benefits. 

Adams was charged with “doctor shopping” the first time in Robertson County on October 11 of this year, involving codeine, a similar pain medication. She pleaded guilty to that charge on December 5.

“We intend to get the message to everyone, no matter what it takes, that TennCare fraud is illegal and anyone committing this crime will be caught,” Inspector General Deborah Faulkner said. “It’s against the law to use TennCare to obtain prescription drugs for any reason other than prescribed, or to use benefits to go quickly from doctor to doctor to get prescription drugs for whatever purpose.”

TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge.  District Attorney General Victor S. Johnson, III 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.”

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