UPDATE: Trial Set for Duo to Face TennCare Fraud Charges in Rutherford County

UPDATED: Rutherford County, TN - A sealed indictment that was handed down by a Rutherford County Grand Jury in 2022 for two suspects believed to be involved in a felony TennCare Fraud Case is making its way through the court process. The two suspects in Rutherford County were originally apprehended for TennCare Fraud after allegedly giving false information, so that one of them could enroll in the state’s healthcare insurance program.

According to the Office of Inspector General (OIG), the arrests of Phillip Johnson and his reported girlfriend Dusty Brown were made with the help of the Rutherford County Sheriff’s Office. Investigators allege the girlfriend provided false documents and statements to the state as to where Johnson’s son was living. A past report showed that statements from Brown resulted in TennCare paying more than $8,440 in fees and claims on behalf of Johnson. In this case, Inspector General Chad Holman said, “Truthful and accurate household composition reporting is the responsibility of TennCare recipients.” Holman went on to state, “When recipients provide false information, they will be investigated to ensure that they are held accountable.”

Reports from the Rutherford County Circuit Courts indicate the charges stem from their alleged criminal activity that dates back to August 1, 2019. A warrant was issued for the arrest of Brown and Johnson, who are now 46-years-of-age, on May 6, 2022. The warrants were served on the duo 4-days later. A plea hearing was previously scheduled for March 1, 2023, but a continuance was granted. The two are currently scheduled for a Pre-Trial Motion on July 14th of this year with a Trial set for August 22, 2023, which is just 10-days after Brown turns 47 and 5-months before Phillips hits 47.

Because the arrests involved two suspects from Rutherford County, the case is being prosecuted by District Attorney General Jennings H. Jones, who serves Rutherford and Cannon Counties. As for the charge of TennCare fraud, it is considered a class D felony. In Tennessee, a class D felony carries the possibility of a 2 to 12-year prison sentence and a fine of up to $5,000.

According to law, anyone convicted in a TennCare fraud case can actually reenroll into the TennCare system, after meeting specific guidelines. The law says, “Any person or entity disqualified from participation in the medical assistance program shall make restitution in the total amount of the medical assistance or underpayment which forms the basis for the conviction before such person or entity can reenroll in the TennCare program.”

To report TennCare Fraud or Abuse, call 1-800-433-3982. You can also email tips about TennCare fraud to TennCare.Fraud@tn.gov.

More Details on the OIG: The Office of the Inspector General, which is separate from TennCare, began full operation in February of 2005 and has identified and investigated more than 130-thousand potential fraud cases leading to more than $9.2 million being repaid to TennCare. The budget for TennCare is comprised of 65 percent federal dollars and 35 percent state dollars. Because TennCare fraud is such a large problem in the Volunteer State, the Office of Inspector General has created a “Most Wanted” list that can be found online at https://www.tn.gov/finance/fa-oig/fa-oig-most-wanted.html. Anyone with information about a wanted subject is urged to use the contact information on the page. There is also a reward program that was established by the Legislature allowing Tennesseans to be eligible for cash rewards when reporting TennCare fraud, if the tip leads to a conviction. Anyone can report suspected TennCare fraud by calling 1-800-433-3982, toll-free, or by logging on to www.tn.gov/oig/ and following the prompts that read “Report TennCare fraud.”

SOURCE: Office of Inspector General, Rutherford County Circuit Court, TCA 71-5-2601

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UPDATE: Trial Set for Duo to Face TennCare Fraud Charges in Rutherford County

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