NASHVILLE – A Cannon County man is charged with TennCare fraud involving “doctor shopping,” or using the state’s public healthcare insurance program to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.
The Office of Inspector General (OIG) with assistance from the Cannon County Sheriff’s Office, today announced the arrest of James Chadwick Emberton, 33, of Woodbury. An indictment accuses him of five counts of fraudulently using TennCare by visiting multiple providers in order to obtain painkillers: Oxycontin, Oxycodone and Endocet. The prescription, the office visit, or both, were paid for by TennCare.
“A lot of healthcare providers are aware of the warning signs of people who are feeding their own or someone else’s addiction with these drugs,” Inspector General Deborah Y. Faulkner said. “As long as there’s a market for these drugs, people will try to accommodate it – but we are intent on keeping this activity out of the TennCare program.”
TennCare fraud is a Class E felony carrying a sentence of up to two years in prison per charge. District Attorney General William Whitesell, Jr. will be prosecuting this case.
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, nearly 1,500 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."