Life was upended for LaShonia Ingram over the past year, and a shadow still follows her around.
Search her name online, and the first result includes the words 鈥渇raud鈥 and 鈥渕ost wanted.鈥
鈥淚t was horrible. I couldn鈥檛 get a job,鈥 said the 42-year-old mother from Memphis, Tennessee. 鈥淎ll doors were being closed in my face.鈥
Ingram resorted to selling purses out of her trunk to support her family. She said even DoorDash and Uber wouldn鈥檛 allow her to work with a felony charge. Her alleged crime? Fraud.
The state of Tennessee accused Ingram of living in nearby Horn Lake, Mississippi, while still enrolled in the state鈥檚 Medicaid program, known as TennCare. It all turned out to be a mix-up, but the damage to her reputation and finances was done.
Every state has to investigate Medicaid fraud committed by doctors and other health care providers, since that鈥檚 usually where the most money can be recovered. Few states crack down on patients as Tennessee does. Tennessee posts the names and photos of people arrested for alleged fraud on a government website and social media. Some even wind up on a 鈥渕ost wanted鈥 list.
The list is maintained by Tennessee鈥檚 Office of Inspector General. The office was launched in 2005 when most of the cases involved drug diversion: People were accused of using TennCare benefits to acquire massive quantities of narcotics to sell on the street. But as federal rules have slowed the illegal prescription drug market, arrests related to Medicaid are instead sweeping up people accused of moving out of state 鈥 often within the same community 鈥 without canceling their benefits.
Ingram was one of 28 Medicaid beneficiaries in Tennessee charged in 2022, according to the Tennessee OIG; more than a third of them were accused of not being a Tennessee resident, with many cases originating in the Memphis area, where suburbs extend into Mississippi.
In Ingram鈥檚 case, Tennessee announced her arrest in a , which said she eluded authorities for nearly a year. Ingram said she didn鈥檛 have a clue about the charges until she got a ticket for not wearing her seat belt.
鈥淭hey pulled me over, and they said, 鈥榊ou have a felony warrant.鈥 And I said, 鈥楺uit lying,'鈥 she recalled. 鈥淚鈥檝e never been in trouble a day in my life.鈥
It took $2,000 to bond out of jail and even more to hire an attorney. Not until more than six months later did prosecutors show her the evidence so she could refute the charges and clear her name.
The explanation ended up being pretty straightforward. During the time she was on Tennessee鈥檚 Medicaid program and living in Memphis, she filed for divorce from her husband who lived nearby in Mississippi. Ingram said they had been separated for years, but her driver鈥檚 license still had the outdated Mississippi address.
After her arrest, Ingram showed her Tennessee lease and electric bills, and the Shelby County district attorney dropped the felony charges.
鈥淲e try to apply the law compassionately,鈥 , who leads the TennCare OIG, told KHN.
Other states have fraud investigation units focused on patients, but they don鈥檛 necessarily name the accused publicly, which happens in Tennessee. For example, keeps the accused anonymous even after they鈥檝e agreed to reimburse the state.
Holman defends Tennessee鈥檚 practice of posting a 鈥渕ost wanted鈥 list for its Medicaid program. He said it鈥檚 supposed to be a deterrent: 鈥淚t鈥檚 not to blast anyone or defame anyone. It鈥檚 to simply take care of the business that鈥檚 at hand, hold people accountable, and do what we鈥檙e here to do,鈥 he said.
As drug-related cases have diminished, enforcement has increasingly focused on ensuring that people enrolled in TennCare live in the state. In Memphis, 20 of the 27 Medicaid fraud cases since 2019 involved questions of state residency, according to the Shelby County district attorney. And prosecutors have dropped at least a half-dozen of those cases because the evidence was so weak.
Holman said his office won鈥檛 overlook low-level offenses.
鈥淭his is not murder,鈥 he said. 鈥淏ut the legislature classified it as a felony, and that鈥檚 the law that I鈥檓 here to enforce.鈥
Holman acknowledged it costs far more to run the TennCare fraud unit than the office will ever recoup from people on Medicaid, who are usually low-income. Even if the state recovered every dollar from charges brought against beneficiaries in 2022, the total would amount to less than $900,000. The office has a . Since its creation in 2005, the OIG has brought in less than $10 million and charged nearly 3,200 people with fraud, according to its .
The rate of arrests has slowed dramatically. It now arrests fewer people in a year than it previously did in a .
About 1 in 4 Americans are on Medicaid or CHIP 鈥 the Children鈥檚 Health Insurance Program. The by more than 20 million since early 2020. And for the first time since the start of the pandemic, states will resume and addresses over the next year. Millions of Americans could lose their Medicaid coverage as a result. It鈥檚 up to each state to determine who is eligible and how to deal with potential fraud in the program.
, executive director of the Tennessee Justice Center, said policing fraud among TennCare beneficiaries takes time and money that otherwise could be spent on something more helpful.
鈥淚t鈥檇 be great if our leaders would get out of the 鈥榞otcha game鈥 and get into the 鈥榞etting people healthy game,鈥欌 she said.
As Medicaid programs restart checks on eligibility, Johnson said, recipients shouldn鈥檛 have to worry that a mistake could eventually get them arrested.
Despite her ordeal, Ingram is bouncing back. Still, she has legal bills to pay and has grown more frustrated at being ensnared by the state鈥檚 Medicaid dragnet.
鈥淭hey made a big mistake,鈥 she said.
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