Two Charged With ''Doctor Shopping''

A man and woman in Hamilton County have been charged in separate cases with "doctor shopping," or going to multiple healthcare providers within a 30-day period to obtain prescriptions for the same or similar controlled substances.

The Office of Inspector General (OIG) today announced the arrest of Clarence J. Rucker, 44, of Red Bank and Gail P. Harrison, 40, of Chattanooga.

Gail P. Harrison, also known as Gail P. Edwards was charged with six counts of fraudulently obtaining controlled substances by "doctor shopping." She is accused of going to several healthcare providers for prescriptions for the painkillers Hydrocodone and Oxycodone. In addition, Harrison was charged with one count of TennCare fraud, one count of obtaining a controlled substance by fraud and one count of identity theft for presenting a pharmacy with a forged prescription for 60 pills of the painkiller Percocet, using TennCare to pay for them.

In a separate case, Clarence J. Rucker was indicted for four counts of TennCare fraud by "doctor shopping" for failing to disclose to his healthcare providers that he was obtaining painkiller prescriptions from other doctors, including Hydrocodone and Oxycodone along with Hydromorphone, which is generic for the painkiller Dilaudid, using TennCare to pay for the physician visits. He is also charged with one count of TennCare fraud and one count of attempting to obtain a controlled substance by fraud for presenting an altered prescription for Oxycodone at a pharmacy, and attempting to use TennCare to pay for it.

"The fraudulent use of TennCare benefits is a serious crime," Inspector General Deborah Y. Faulkner said. "Doctors and pharmacies across the state are working with law enforcement officials to pursue these crimes whenever they are suspected."

TennCare fraud is a Class E felony carrying a sentence of up to two years per charge in prison. District Attorney William H. Cox will be prosecuting these cases.

The OIG, a law enforcement agency separate from TennCare, began full operation in February 2005 and has worked cases leading to the arrest of over 700 individuals for TennCare fraud, with nearly $1 million paid in restitution to TennCare, and total estimated cost avoidance in TennCare of over $75 million, according to latest figures.

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.tncarefraud.tennessee.gov and follow the prompts that read "Report TennCare Fraud."