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Terms Used In Tennessee Code 71-5-2509

  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Enrollee: means an individual eligible for and enrolled in the TennCare program or in any successor medicaid program in Tennessee. See Tennessee Code 71-5-2503
  • Inspector general: means the person who directs the office of inspector general, who shall report directly to the commissioner of finance and administration. See Tennessee Code 71-5-2503
  • Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
  • Recipient: means any person who has been determined eligible to receive benefits under part 1 of this chapter, and who has received such benefits. See Tennessee Code 71-5-2503
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • Subpoena: A command to a witness to appear and give testimony.
  • TennCare: means the program administered by the single state agency, as designated by the state and CMS, pursuant to Title XIX of the Social Security Act ( 42 U. See Tennessee Code 71-5-2503
(1) The office of inspector general, when conducting any investigation relating to TennCare fraud or abuse, shall have the power to issue subpoenas, and compel the attendance of witnesses, the examination of such witnesses under oath, and the production of books, accounts, papers, records, and documents relating to such investigation.
(2) In the case of a failure of any person, firm, or corporation so subpoenaed to attend or to produce the specified records, and after reasonable notice to such person, firm, or corporation, the office of inspector general may seek judicial enforcement of the subpoena by filing, through the attorney general and reporter, a petition with the circuit or chancery court of Davidson County or of the judicial district in which such person, firm, or corporation resides. Such petition shall incorporate or be accompanied by a certification regarding the notice given and the failure of such person, firm or corporation to attend or produce the records.
(3) Upon the filing of such a petition in proper form, the court shall order the person, firm, or corporation named in the petition to appear and show cause why they should not comply with the subpoena or be held in contempt for failure to comply. The court shall have authority to employ all judicial power as provided by law to compel compliance with the subpoena, including those powers granted in §§ 29-9-103 – 29-9-106. The court shall be authorized to impose costs and sanctions against any such person, firm, or corporation, in the same manner and on the same bases as may be imposed for failure to comply with judicially issued subpoenas under the Tennessee Rules of Civil Procedure.
(4) The court may order the person, firm, or corporation to comply, and shall have the authority to punish each day of failure to comply with such order as a separate contempt of court.
(5) The subpoena enforcement remedies set forth in this subsection (a) shall be cumulative, and not exclusive, of any other remedies provided by law for the enforcement of such subpoenas.
(b) The office of inspector general shall have the power to compel the production of current and former employment records during an investigation. Employment records include, but are not limited to, employment details, wages, and insurance information of TennCare applicants and enrollees. Employment records shall be open to inspection and be subject to being copied by an office of inspector general representative at any reasonable time and as often as may be necessary. The office of inspector general shall also have the right to compare information reported to TennCare by applicants or enrollees with data maintained by the credit bureaus.
(c) The complete patient record of an enrollee or recipient generated during the TennCare enrollment period shall be made available to the office of inspector general upon request. This includes any and all services, goods and pharmaceuticals dispensed regardless of payment source. Access to these records under this section may occur during and after enrollment in the TennCare program. Records accessed during an investigation shall be protected in accordance with state and federal privacy laws.
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