NASHVILLE (press release)—A grandmother and grandson are each charged with TennCare fraud involving doctor shopping, which is going to multiple doctors in a short period of time to obtain prescriptions for similar controlled drugs, using TennCare as payment.
The Office of Inspector General (OIG) announced the arrests of Lydia P. Smith, 64, and her 23-year old grandson Michael D. Smith, both of Dayton. The Rhea County Sheriff’s Office assisted in the arrests.
The grandson is accused of forging his grandmother’s signature in order to obtain a prescription for the painkiller Oxycodone. He’s charged with TennCare fraud and obtaining a controlled substance by fraud. In addition, Michael Smith is charged with two counts of fraudulently obtaining controlled substances by doctor shopping and two counts of obtaining a controlled substance by fraud. Charges accuse him of doctor shopping for controlled substance prescriptions.
The grandmother, Lydia Smith, is charged with doctor shopping and obtaining a controlled substance by fraud.
“The abuse of TennCare pharmacy benefits, especially involving pain medications, is our number one priority,” Inspector General Manny Tyndall said.
“People who try to use TennCare to subsidize prescription drug sales or drugs for recreational use will be prosecuted.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge. District Attorney General J. Michael Taylor is prosecuting.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $5 million being repaid to TennCare with a total estimated cost avoidance of over $176 million for TennCare, according to latest figures. To date, 2,237 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.”