Giles Co. Woman Charged with TennCare Fraud

Thursday, April 28, 2022 | 02:24pm
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NASHVILLE –  A Giles County woman is charged with TennCare fraud and theft of services in connection with allegedly claiming dependents in her household so she could obtain healthcare insurance benefits through the program.

The Office of Inspector General (OIG) and the Giles County Sheriff’s Department today announced the arrest of 42-year-old Nicole Joyce-Madison. Investigators say her enrollment in TennCare cost the program more than $45,788 in fees and claims.

But that’s not all: Joyce-Madison is also charged with bringing contraband into a penal institution for the alleged marijuana cigarette she was found to possess while being booked on the initial charges related to TennCare fraud.

“The fraudulent representation of household composition in this case indicates how tax dollar monies are misappropriated by those that abuse the TennCare system,” Inspector General Chad Holman said. “The  result of this fraud can be large sums of taxpayer dollars that ultimately affects every Tennessean and we will continue to pursue these cases so people are held accountable.”

TennCare is a class D felony and theft of services is a Class C felony.  The case is being prosecuted by 22nd Judicial District Attorney General Brent A. Cooper who serves Giles, Lawrence, Maury and Wayne counties.

The OIG, which is separate from TennCare, began full operation in February 2005 and has identified and investigated more than 130,349 potential fraud cases leading to more than $9.2 million being repaid to TennCare.  In the last year ending June 30, 2021, total estimated cost avoidance was more than $7.5 million. TennCare's budget is comprised of 65 percent federal and 35 percent state dollars. To date, 3,166 people of been charged with TennCare fraud.

The OIG’s “Most Wanted” list can be located 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.

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.”