Woman charged with TennCare fraud for third time

By Chris Butler | Tennessee Watchdog

NASHVILLE — Tennessee officials make stern warnings about how tough they are on TennCare fraud, but they don’t seem to haven’t gotten through to a Knox County woman accused of committing this crime repeatedly since 2011.

Knox County grand jurors recently indicted Nancy Elaine Horsley, 47, on three counts of doctor shopping to obtain prescriptions for controlled substances, using TennCare payments, according to the state’s Office of Inspector General.

“She is also charged with three counts of obtaining a controlled substance by fraud and is being held in the Knox County jail on a $200,000 bond,” according to a TN OIG release.

TennCare is Tennessee’s version of Medicaid.

Horsley’s most immediate prior arrest occurred six months ago, when authorities indicted her on 11 counts of TennCare fraud, as well as 11 counts of obtaining a controlled substance by fraud, the TN OIG said.

Her first arrest on these charges occurred three years ago.

“Her first TennCare fraud arrest came in December 2011, when she was charged with six counts of doctor shopping for drugs. She pleaded guilty to all six counts and was sentenced to two years supervised probation as well as making restitution to the state in the amount of $2,111.24,” according to the release.

What can state officials do to clamp down on someone charged with repeatedly committing TennCare fraud?

TN OIG officials did not immediately return requests for comment Friday, and Horseley’s contact information was unavailable.

Regardless of these multiple arrests, Inspector General Manny Tyndall still said in his release that “abusing TennCare will have serious repercussions.”

Tyndall’s release describes TennCare fraud as a Class E felony carrying a sentence of up to two years per charge in prison.

To date, 2,205 people have been charged with TennCare fraud, the release said.

More than 1.2 million Tennessee residents participate in TennCare, which has a budget of $9 billion, according to TennCare’s website.

Exactly 65 cents of every dollar spent on medical services for TennCare enrollees comes from the federal government, while the remainder comes from the state, the website added.

Contact Christopher Butler at chris@tennesseewatchdog.org

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