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Hillsboro Man Charged With TennCare Fraud

James Richard Edwards

James Richard Edwards

A Coffee County man is charged with TennCare fraud after an undercover operation that led to indictments of 60 people. So far, a total of 40 have been arrested.
The Office of Inspector General (OIG) has announced the arrest in the investigation that involved officers from Manchester Police and the Coffee County Sheriff’s Office. Most of the charges involve prescription drug fraud.
James Edwards, 47, of Hillsboro, Tennessee is charged with two counts of TennCare fraud in connection with unlawfully and knowingly selling and delivering a controlled substance obtained by using TennCare benefits. Authorities say Edwards used TennCare to obtain the painkiller Oxycodone, a Schedule II controlled substance, and on two separate occasions sold a portion to an undercover agent.
“This kind of multi-agency cooperation goes a long way toward our goal of stopping prescription drug fraud in the TennCare program,” Inspector General Deborah Faulkner said. “We are working with officers across the state to find people using TennCare to obtain drugs fraudulently, or who are selling their prescription drugs to others.”
TennCare fraud is a Class E felony, carrying a sentence of up to two years in prison per charge. District Attorney General C. Michael Layne is prosecuting.
The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to over $3.5 million paid in restitution and recoupment to TennCare, with a total estimated cost avoidance of over $173 million for the TennCare program, according to latest figures. To date, 2,088 people have been charged with TennCare fraud.
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.tn.gov/tnoig/ and follow the prompts that read “Report TennCare Fraud.”