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Frequently Asked Questions
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Answers
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| 1. What statutory authority does the OIG have to perform its work? |
See T.C.A. 71-5-2505 et
seq. |
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2. Does the OIG have any administrative rules in addition to 'Cash for Tips'? |
Yes. See Chapter 0620-4-2 Rules of Procedure for Contested Cases before the Inspector
General. |
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3. How does a Spanish speaking enrollee obtain transportation to a doctor appointment?
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The number to the Spanish hotline is 1-866-311-4290
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4. How do I change providers?
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Call 1-866-311-4287 to change providers.
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5. How do I request a pharmacy change?
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Call 1-866-311-4287 to change pharmacists.
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6. What exactly is FRAUD?
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Fraud is an intentional deception or misrepresentation made by a person with knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable Federal or State Law.
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7. Do you handle Food Stamp Fraud?
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Yes and No. Sometimes we can work the case if another issue or fraud is involved. If not, then we forward this to the Food Stamp Fraud Division.
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8. How do I report Fraud in another State?
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Call our office and let's determine if it is actually fraud in Tennessee or another state. If fraud is occurring in another state then we will provide a phone number for you
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9. Can you be on TennCare and have other insurance?
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Yes. TennCare will always be secondary insurance.
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| 10. Who can I talk to about my monthly medication limits? |
TennCare pharmacy. The number is 1-888-816-1680 |
| 11. What do I do with TennCare mail that comes to my address but it is for someone that does not live here? |
If you think that it might be of a fraudulent nature call our office. If you think that it is a mistake call 1-866-311-4287 |
| 12. Do you handle all fraud at this number? |
The Office of Inspector General works with TennCare fraud. |
| 13. How do I get a new card? |
Call the eligibility hotline 1-866-311-4287 |
| 14. Is Weight Watchers a TennCare benefit? |
It depends upon the type of TennCare that you are receiving. You would need to see a Primary Care Physician or call your MCO for approval
to attend. |
| 15. Who do I speak to for Estate Recovery? |
Call the office of General Counsel for TennCare 1-866-311-4287. |
| 16. What is the phone number for the MCOs? |
You can find the number for the MCOs and the BHOs on the TennCare website. |
| 17. What is HIPAA? |
Health Insurance Portability and Accountability Act, (HIPAA) |
| 18. Can the OIG obtain private health information? |
The Office of Inspector General is a healthcare oversight agency and may obtain protected health care information or PHI. Because the OIG requests information for health care oversight activities, 'minimum necessary' standards do not apply to those disclosures to the OIG. (see 45 C.F.R. §§164.501, 164.512(d), 165.502(b)(2)(v), and 162.52(d); Tenn.CodeAnn §71-5-2509 |