Bradley Co. Woman Pleads Guilty to TennCare Fraud

Tuesday, November 14, 2017 | 2:06pm

NASHVILLE, Tenn. –   A Bradley County woman has pleaded guilty to TennCare fraud and must repay the state for healthcare insurance benefits she received.

The Office of Inspector General (OIG) today announced that 34-year old Amber Ridley of Cleveland, Tennessee, pleaded guilty to TennCare fraud and theft of services and must now repay TennCare $31,459.32. She must also pay another $8,613.52 to Blue Cross Blue Shield of Tennessee, a TennCare managed care organization, and she’ll be on probation for five years in Bradley County.

Ridley was arrested in September more than a year after an indictment accused her of fraudulently obtaining TennCare benefits by falsely claiming her minor child was living in her home as a dependent. Authorities say the child was actually living in New York with adopted parents. District Attorney General Stephen D. Crump prosecuted this case.

“People who lie, cheat or steal to get TennCare healthcare insurance benefits intended for people truly eligible will be caught and prosecuted,” Inspector General Manny Tyndall said. “We are pursuing these type of cases across the state.”

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, 2,915 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.”

TennCare Fraud