North Carolina Couple Charged with TennCare Fraud
NASHVILLE – A North Carolina couple is charged in connection with allegedly reporting they still lived in Tennessee so they could remain enrolled in TennCare.
The Office of Inspector General (OIG) today announced the arrest of 37-year-old Laura Pickelsimer and her husband Alex Pickelsimer, 38. Laura is charged with TennCare fraud and both Picklesimers are charged with theft of services.
According to investigators, the Pickelsimers lived in North Carolina when Laura reported a Tennessee address to the state so the family could continue obtaining healthcare services through the state’s TennCare Medicaid program. As a result, TennCare paid more than $47,277.00 in fees and claims.
“OIG prides itself in protecting Tennessee’s great citizens and their important tax dollars,” Inspector General Kim Harmon said. “We will continue to pursue those attempting to take advantage of our Medicaid system and bring them to justice.”
The theft of services charge is a class C felony and the TennCare fraud charge is a class D felony. The case is being prosecuted by District Attorney General Stephen D. Crump of the 10th Judicial District serving Bradley, McMinn, Monroe and Polk County.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated over 5,760 criminal cases leading to more than $10.8 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to latest figures. TennCare’s budget is comprised of both federal and state dollars, 65% and 35% respectively. To date, 3,139 people have been charged with TennCare fraud.
To access the OIG most wanted list, visit 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.
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 or by logging on to www.tn.gov/oig/ and following the prompts that read “Report TennCare fraud.”