Tuesday, January 11, 2011

Putnam Woman Charged With TennCare Fraud

A Putnam County woman has been indicted in Rutherford County for TennCare fraud involving “doctor shopping,” or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.  The Office of Inspector General (OIG) with the assistance of the Rutherford and Putnam County Sheriff’s Offices, today announced the arrest of Anna Ledford, 53, of Monterey. Ledford is charged with three counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.” Ledford failed to disclose to her doctor that she had seen other physicians within a 30-day period and received a prescription for the strong painkillers Morphine Sulfate, Oxycodone and Endocet, a brand drug for Percocet, with the physician office visits and prescriptions being paid for by TennCare.

“Certain prescription drugs are classified as controlled substances because they have a dangerous potential for abuse and addiction,” Inspector General Deborah Faulkner said. “TennCare pays for such medications when prescribed under the direction and supervision of a physician, but we’re committed to pursuing those cases involving fraud and abuse especially when these classifications of dangerous drugs are involved.”

The TennCare fraud charges against Ledford could result in a two year sentence per charge, if convicted. District Attorney General William C. Whitesell, Jr. 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 1,300 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."