Ohio Woman Charged with TennCare Fraud

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Friday, December 08, 2017 12:29pm

NASHVILLE, Tenn. – After being on the run for eight months, an Ohio woman has been returned to Williamson County where is accused of TennCare fraud involving doctor shopping, which involves visiting multiple providers in a short time period to obtain prescription drugs.

The Office of Inspector General (OIG), with the assistance of the Williamson County Sheriff’s Department, today announced the arrest of Lori Fiss, also known as Lori Burris, 46, of Hamilton County, Ohio. 

Fiss is charged with five counts of doctor shopping with TennCare, seven counts of prescription drug fraud and two counts of identity theft. Authorities say she used TennCare to doctor shop for Oxycodone and Hydrocodone. She was arrested in Hamilton County, Ohio and returned to Williamson County, where she previously lived.

Tennessee communities are simply no longer tolerating the fraudulent misuse of prescription drugs, especially when TennCare is involved,” Inspector General Manny Tyndall said. “We are aggressively pursuing and prosecuting these cases across the state as communities battle the epidemic of opioid abuse.”

District Attorney General Kim R. Helper is prosecuting. TennCare fraud is a Class D felony punishable by up to four years in prison per charge.

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, 2,930 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 800-433-3982 toll-free from anywhere in Tennessee, or visit the website and follow the prompts that read “Report TennCare Fraud.”

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