Jefferson County Woman Charged with TennCare Fraud

A Jefferson County woman is charged with TennCare fraud for falsely reporting her income in order to obtain healthcare insurance benefits through the state program.

The Office of Inspector General (OIG) with the assistance of the Jefferson City Police Department today announced the arrest of Consuelo Morales, 44, of Jefferson City. A Jefferson County Grand Jury charged Morales with TennCare fraud theft of property over $10,000. The indictment says Morales knowingly obtained TennCare benefits with the intent to avoid payment for services by failing to properly report to the state her spouse’s income, real estate assets and the fact that her family was eligible for private insurance through her spouse’s employer.

“Providing false information in order to receive TennCare benefits is a crime Tennesseans will not tolerate,” Inspector General Kim Harmon said. “We work hard to preserve TennCare resources for those truly in need.”

District Attorney General James B. Dunn is prosecuting. TennCare fraud is a class D felony punishable by up to four years in prison. Theft of property over $10,000 is a Class C felony punishable by up to six 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, 3,063 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.”