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Pair Charged With Tenncare Fraud

Wednesday, February 03, 2010

Two area residents have been charged with TennCare fraud.

Andrew Wilbourn Jr. and Willard Land are charged with selling prescription medication paid for by TennCare to a Sequatchie County undercover informant.

Wilbourn is charged with selling Adderall and Land with selling hydrocodone.

Officials said 1,118 people have been arrested and charged with TennCare fraud and related criminal charges since Nov. 1, 2006, officials said.

These arrests include charges for doctor shopping, forged prescriptions, enrollees living outside of Tennessee, those who falsely reported their income and do not qualify for TennCare, or were charged with theft of TennCare services (many of whom were using another person's TennCare card).

Rep. Eric Watson said, "One of the biggest strains on our budget is TennCare, and we need to make sure that those who really need TennCare, get TennCare. When a person receives TennCare through fraudulent actions, he or she takes away from a person who really needs it, and the violator should be prosecuted.

"The Office of the Inspector General offers a cash reward to anyone who reports TennCare fraud that results in an arrest and conviction, and I encourage everyone to report fraud and abuse to the TennCare Fraud Hotline at 1-800-433-3982. If you know or suspect someone that fraudulently receives services such as families first, food stamps, medicaid, child care, or vocational rehabilitation, please contact the Human Services Fraud Hotline at 1-800-241-2629."

The mission of the Tennessee Office of Inspector General is to identify, investigate, and prosecute persons who commit fraud against TennCare. The OIG is authorized to investigate civil and criminal fraud and abuse of the TennCare programs, or any other violations of state criminal law related to the operation of TennCare, including allegations of fraud or abuse involving TennCare managed care organizations (MCOs). They cooperate with the Medicaid Fraud Control Unit at the Tennessee Bureau of Investigation and refer instances of provider fraud and abuse to that unit to furnish the public with information about the fraud and abuse laws pertaining to TennCare. They
provide legal assistance to the attorney general and the district attorneys general in initiating and handling proceedings in appropriate TennCare fraud and abuse cases, including criminal prosecutions, civil recoveries, and forfeitures. They employ qualified law enforcement officers with authority to enforce the fraud provisions. They pay cash rewards to citizens who provide information regarding TennCare fraud which leads to a criminal conviction, and they subpoena witnesses and records in connection with any investigation into TennCare fraud or abuse.


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