Department of Finance & Administration
Mark Emkes, Commissioner

DAVIDSON COUNTY WOMAN CHARGED WITH TENNCARE "DOCTOR SHOPPING"

NASHVILLE - A Davidson County woman is under indictment for TennCare fraud involving “doctor shopping,” or using the state’s public healthcare insurance program to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.

The Office of Inspector General (OIG) with assistance from the Davidson County Sheriff’s Office today announced the arrest of Roxie Ann Haliburton, 40, of Nashville. Haliburton is charged with two counts of fraudulently using TennCare to obtain a controlled substance by “doctor shopping.”

The indictment alleges that Haliburton failed to disclose to her doctor that she had seen other physicians within a 30-day period and received a prescription for the painkiller Dihydrocodeinone, with the physician office visits and/or prescriptions being paid for by TennCare. 

"The ‘doctor shopping’ law gave us a valuable tool in cracking down on people who are abusing the program,” Inspector General Deborah Faulkner said. “Medical professionals across the state have applauded this law and our efforts to stop people from doing this and are helping us develop these cases.”

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney General Victor Johnson will be prosecuting this case.

The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $173 million for the TennCare program, according to latest figures.  To date, nearly 1,500 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."