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Four Charged with TennCare Fraud in Unicoi, Cannon Counties

Released on Mon, Jun 01, 2009 - 12:40 pm under

NASHVILLE – Four people are charged with TennCare fraud in separate cases stretching from Woodbury to Erwin, Tennessee.

The Office of the Inspector General (OIG) today announced the four arrests, which all involve individuals obtaining prescription medications paid for by TennCare, with the intent of selling them.

The arrests include:

  • Nina J. Mayfield-Odom, 30, of Woodbury, charged with one count of TennCare fraud, her second TennCare fraud arrest.  She used TennCare to fill prescriptions for the painkiller hydrocodone, butalbital (pron. Byoo-TAL-bi-tal), which is a barbituate, and gabapentin (pron. Ga-bah-PEN-tin), which is a drug used mainly to treat seizures.  An indictment charges her with the intent to unlawfully distribute a portion of the drugs.  She was charged with TennCare fraud once before, in September of 2006. 
  • Christa L. Sams, 29, of Erwin, charged with one count of TennCare fraud for filling a prescription for the painkiller percocet and using TennCare to pay for it. An indictment also charges Sams with intending to resell the drugs.
  • Luther Smith, 55, of Erwin, has been charged with one count of TennCare fraud for using  TennCare to obtain a prescription for the painkiller hydrocodone while intending to resell a portion of the pills.
  • Phillip Shelton, 33, of Erwin, charged with two counts of TennCare fraud and one count of theft of services.  Shelton on two separate occasions used TennCare to obtain prescriptions for the drug suboxone, which is used to treat addiction to drugs like heroin or morphine.  Charges say he intended to resell a portion of both prescriptions.

 

If convicted, Shelton could be sentenced to up to six years on the charges, which are class D and E felonies.  The other three could be sentenced up to two years for the TennCare fraud charge which is a class E felony.  District Attorney General Anthony Clark will be prosecuting the three Unicoi cases and District Attorney General William Whitesell, Jr., will be handling Mayfield-Odom’s case.

"The fraudulent misuse of TennCare pharmacy benefits is simply no longer being tolerated by communities, providers and law enforecement,” Inspector General Deborah Y. Faulkner said. "We are working closely with local law enforcement agencies and pharmacies across the state to investigate and prosecute these types of crimes."

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $2.6 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $165 million for the TennCare program, according to latest figures.  To date, over 920 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."