A Maryville, Tennessee resident has been convicted of engaging in TennCare fraud, defined as the theft of services, particularly involved in the practice of "doctor-shopping" for pain medication. According to a statement from the Office of Inspector General (OIG), Amanda Allen (Gilreath), who is 42 years old, was sentenced to nearly two years of supervised probation and is now obliged to pay back $4,152.01 in restitution to TennCare, plus an administrative fee to the Criminal Court Clerk.
The conviction was a result of Allen visiting multiple hospitals between April 3, 2020, and June 10, 2020, where she received prescriptions for pain meds from each without informing them of her previous prescriptions which is a clear violation of the policies set to prevent abuse of the system, the OIG emphasized that they consider this a serious offense and would continue to crack down on such fraudulent activities, as part of their efforts to preserve the integrity of the healthcare system and to ensure that resources are available for those truly in need. Inspector General Chad D. Holman stated that “Receiving pain medication(s) from different providers within 30 days and without disclosure of those previous prescriptions constitutes “doctor-shopping” and will be pursued by our office,” as detailed by the Office of Inspector General.
Prosecution of Allen's case was led by Knox County District Attorney General Charme P. Allen. The IG's office intends to not just penalize but also to recoup losses from fraudulent activities to maintain financial integrity.
The OIG also encourages public participation in identifying TennCare fraud through their Cash for Tips Program, which pays cash rewards for tips that lead to convictions, to contribute to these efforts, one can report suspected fraud by calling 1-800-433-3982, or emailing [email protected] and details are also available on the OIG's official website.
