Seven people living in the same Bridgeport, Alabama apartment complex are now charged with Medicaid fraud in neighboring Tennessee. The state line is just six miles from Bridgeport. Their whole scheme unraveled because of an anonymous tip.
All seven claimed they were Tennessee residents so they could receive TennCare, the state’s Medicaid program. In Tennessee, Medicaid fraud is a class D felony, punishable by prison sentences running from two to 12 years.
If the Medicaid fraud’s theft of services amounts to $10,000 or more, it becomes a Class C felony, and if the amount stolen is $60,000 and up, it becomes a Class B felony.
The first five defendants in the case were charged in June. They include Bradley Parker, 45, who allegedly reported he and his minor child were Tennessee residents to qualify for TennCare, but actually lived in Alabama. Amber Parrish, 23, Robin Miller, 31, Cassandra Henry, 29, and Jacqueline Shrum, 32, were similarly charged with fraudulently claiming they and their minor children were Tennessee residents to receive TennCare benefits.
A few days later, Ladreamer Garrett, 27, faced the same charges. Just a month before applying for TennCare, Garrett signed a lease for her Bridgeport apartment. In July, a seventh Bridgeport resident, Crystal Price, 36, faced charges of TennCare fraud and theft of services of more than $2,500 but less than $10,000.
All seven face up to four years in state prison, if convicted.
Alabama vs. Tennessee
It is not clear why these defendants decided to enroll in TennCare rather in Alabama’s Medicaid program, as enrollment in their own state’s Medicaid program is not a crime if they are eligible. Perhaps they were driven by the different eligibility levels between the states.
In Alabama, children and pregnant income are eligible for Medicaid if their income is 141 percent of the Federal Poverty Level, while in Tennessee the eligibility level is higher, at 195 percent of the FPL.
Medicaid also provides coverage for parents/caretakers, but eligibility is just 13 percent of the FPL in Alabama and 103 percent in Tennessee. It is possible that those accused would not have qualified for benefits in Alabama based on their income, but did qualify in Tennessee.
Out of State Services
Under Alabama law, if those accused had enrolled in the state’s Medicaid program rather than fraudulently enrolling in Tennessee, they still might have been able to obtain services in Tennessee under certain circumstances. These include meeting any of the following conditions, according to Alabama Medicaid:
- Medical emergency
- Medical services are necessary, and the individual’s health is endangered if required to travel to the state of residence
- The state determines, as per medical advice, that the needed medical services or supplementary services are more readily available in the other state.
- It is a general practice for recipients in a particular locality to use medical resources in another state.
Whistleblowers are the New American Heroes
If you simply want to remain anonymous and aren’t interested in a reward, feel free to call 1-800-MEDICARE. If the case only involves Medicaid, you can contact your state Medicaid Fraud Control Unit as well.
If you are interested in collecting a cash reward and best protecting yourself from illegal retaliation, contact our hotline number. All inquiries are kept confidential. We do not charge for our services.
For more information, contact one of our operators toll free at 888.742.7248. You can also contact us online.