Pubdate: Wed, 06 Oct 2004 Source: Tennessean, The (TN) Copyright: 2004 The Tennessean Contact: http://www.tennessean.com/ Details: http://www.mapinc.org/media/447 Author: Bonna De La Cruz Bookmark: http://www.mapinc.org/find?136 (Methadone) Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) TENNCARE DRUG RESALE INVESTIGATION WIDENS TBI Checking To See If doctors In Scam TennCare and the TBI have joined Metro police to investigate how an east Nashville family ended up with TennCare prescription drugs they sold on the streets. The Nashville case involves Mary Francis Denton, 59, and her granddaughter, Misty Bryan Allen, 22, of McClurkin Avenue. They were arrested on drug charges Monday after police said they sold painkillers OxyContin, methadone and Lortab illegally after obtaining the medications by being on TennCare. TennCare officials would not say how long the two had been on TennCare, citing rules that protect enrollees' privacy. It was unclear yesterday whether Denton and Allen are still eligible for TennCare benefits, Potter said. TennCare is investigating what kinds of services the women got and how they got them, said Lola Potter, spokeswoman for the newly created TennCare Office of Inspector General. The post, created by Gov. Phil Bredesen earlier this year, is headed by Deborah Faulkner, former acting chief of Metro police. At the same time, the Tennessee Bureau of Investigation is looking into whether doctors writing prescriptions and other providers were part of the scam, Potter said. TennCare does not require co-payments for drugs or place limits on how many an enrollee can get. A plan by Bredesen to place limits on TennCare enrollees would not necessarily crack down on this kind of abuse. Medicaid enrollees would not be required to pay co-payments, and 80% of enrollees would not be subject to limits of six prescriptions per month. A more aggressive office of in-spector general, which is hiring 71 more staffers and undercover agents, should help, Potter said. Last calendar year, the TennCare fraud and abuse unit handled about 30,000 tips, most of them dealing with enrollees not truthful about income and access to private health insurance, Potter said. Similar cases to the east Nashville incident happen but are not common, Potter said. She did not know how many such cases were under investigation. Once a TennCare enrollee is jailed on either drug or other offenses, he or she is taken off of the program, Potter said. The state is awaiting word from the federal government whether it can allow TennCare to drop coverage of people who have violated fraud and abuse laws but have not been convicted, Potter said. - --- MAP posted-by: Larry Seguin