Tenn. Code Ann. § 71-5-2601 - Offenses, Penalties, Remedies, and Limitations Under TennCare

Any person who provides a false statement or conceals a material fact to obtain medical assistance benefits under TennCare, benefits from making a false statement regarding income, makes a false statement regarding controlled substance benefits with the intent to deceive may be guilty of a Class E felony.   

Any person, firm, corporation, or other entity, other than a beneficiary or recipient of medical assistance who knowingly obtains or aids a person to present a false claim for payment under TennCare is guilty of a Class D felony unless the value of services meets the threshold for a Class B or C offense.  A person firm, corporation or other entity commits an offense when willfully providing a false statement regarding another person’s medical condition or eligibility for medical assistance.  Such an offense is a Class D felony unless the value of services meets the threshold for a Class B or C offense.  Any person, firm, corporation or entity is guilty of a Class D felony if he/she falsifies a material fact, makes a false statement, or makes or uses materially false writing in connection with an investigation of a violation of the offenses stated above.  


In addition to other penalties set forth by law, a court may also order restitution be paid to the TennCare program, report the person or entity to the appropriate licensing board, and may order the person or entity disqualified from participation in the medical assistance program.