A McMinn County woman accused of obtaining TennCare benefits she was not eligible to receive must repay the state for medical and pharmacy services provided through the state’s health care insurance program.
The Office of Inspector General (OIG) on Thursday announced that Traci B.
Hamilton, 44, of Niota, pleaded guilty to theft of services over $10,000. She’s been ordered make restitution to TennCare in the amount of $18,346.85 and was sentenced to three years of probation.
Ms. Hamilton was arrested June 2015 when she was charged with inaccurately reporting her household income in order to be appear eligible for TennCare benefits. District Attorney General James Dunn prosecuted this case.
“This is a common ploy used by people who want to make themselves look poor – on paper – while the taxpayers are picking up the tab for their medical services,” Inspector General Manny Tyndall said. “We have uncovered various schemes that people are using to defraud the TennCare program, but bringing these folks to justice sends a message that we’re going to prosecute these cases.”
Until June 30, 2016, TennCare fraud was classified as a Class E felony carrying a sentence of up to two years in prison per charge. As of July 1, 2016, TennCare fraud was changed to a Class D felony punishable by up to four years in prison.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to more than $3 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures. To date, 2,674 people have been charged with TennCare fraud.
Anyone can report suspected TennCare fraud by calling 1-800-433-3982 toll-free from anywhere in Tennessee, or visit the website and follow prompts that read “Report TennCare Fraud.”