Wednesday, December 17, 2008

Sign of the Times: More Tennesseans ripping off TennCare

Posted by on Wed, Dec 17, 2008 at 8:54 AM

The often embattled, frequently nearly financially insolvent TennCare--the state's health insurance program for the poor and uninsurable--has jumped more than its share of hurdles. Ask anyone at all familiar with the program back in the early part of this decade and you'd probably hear this: I know an unqualified someone bilking TennCare.

So the Office of Inspector General was set up, now manned by former Nashville deputy police chief Deborah Faulkner, in charge of 12 agents responsible for rooting out fraud. But in the current battered economic climate, Faulkner may need more feet on the ground. Incidences of fraud--the fraud they know about--are more plentiful than they've ever been. Her office's investigations led to 29 arrests over the span of three days last week--a milestone for the fledgling oversight group.

"As the economy worsens we have more people on Medicaid," said spokeswoman for the Department of Finance and Administration Lola Potter. "You have more people so you have more fraud."

On Friday a woman was arrested for forging prescriptions, identity theft, and possession of a controlled substance with a prescription--an increasingly common sight on Metro Nashville arrest reports. Often, TennCare enrollees will alter prescriptions and sell the excess to pad what little income they have coming in.

With prescription drugs comprising an increasing portion of the drug market these days, local law enforcement has been happy to have their help, Faulkner said. It's yet another sign of the times, with employers and their employees unable to afford insurance, TennCare can rest assured that it's insureds will swell as their wallets collapse.

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