Life Lessons

TennCare Fraud

TennCare is the State of Tennessee’s health care insurance program that aims to provide health insurance to the uninsured through the state’s Medicaid program by utilizing managed care. Unfortunately there are many people who abuse the TennCare system and commit TennCare fraud. Punishment for TennCare fraud is currently not severe enough and people continue to commit TennCare fraud. Let's examine what happens when someone commits TennCare fraud and what the punishment for TennCare fraud is.

Being accused of TennCare Fraud


Punishment for TennCare Fraud

Some people try to play by the rules, and yet get accused of TennCare fraud. Why? Even if you did not commit the TennCare fraud yourself, going along with the Human Services' decisions and accepting the TennCare benefits without saying anything can criminate you of TennCare fraud, just like in the Enron case - not talking is a crime.

In Tennessee, when people receive benefits from TennCare, they tend to not question it, thinking it's God's gift to them. They don't take the initiative to request their files and check for incorrect items on their files. This is a common problem and if there are no problems down the road, then great. However, when there is a problem, then you are the guilty one, not the Human Services case workers.

Going to court for TennCare Fraud case

When you are accused of TennCare fraud, you will have to go to court. Among the TennCare fraud charge, you may be facing other charges. It is common to be accused of multiple counts, 10 or even 20 counts. DON'T BE ALARMED YET! Most counts will be dropped in court. Also bear in mind that if you go to court for TennCare fraud or other charges, then there will be plea bargain and deals to be made. You need to look into whether you want to make these deals carefully. Not all plea bargains or deals will result in your favor.

Pleading No Contest to the TennCare fraud charge

In Court for TennCare fraud charge and other charges, many charges will be dropped and if all your charges were dropped but one or two and one happens to be the TennCare fraud charge that was not dropped, they may ask you to plead "no contest". No contest is really like a guilty plea which they will tell you that it is in your best interest to plead "no contest".

However, many people plead "no contest" because they are afraid that if they did not then the TennCare fraud case could go to trial and it they were then found guilty of the TennCare fraud then they could go to prison. Most people dread the idea of going to prison especially when they have kids to take care of that they plead no contest.

Once you plead "no contest" the D.A. will likely slab a fine on your case. You will find yourself owing the state of Tennessee a large sum of money depending on your TennCare case. A TennCare fine or court judgement of $20,000 is common as well as putting you on probation. Probation is a common punishment for TennCare fraud.