MEMPHIS, TN — A Memphis nurse practitioner has been arrested on charges of defrauding Tennessee's Medicaid program after state investigators determined she billed for patient services while traveling outside the United States, according to the Tennessee Bureau of Investigation.
Valarie Kershaw Berry, 45, faces 23 counts of TennCare fraud and one count of theft of property valued between $10,000 and $60,000, as reported by the TBI. Authorities arrested Berry on March 4, 2026, following a multi-year investigation into fraudulent billing practices.
The Investigation
The TBI's Medicaid Fraud Control Division launched its investigation in April 2022 after receiving a referral from the U.S. Attorney's Office regarding suspected fraudulent billing to Tennessee's Medicaid program, according to statements from the agency.
Investigators determined that Berry was out of the country from May 16 through May 20, 2022 — a four-day period during which TennCare was billed for 23 separate patient office visits and prescription services, as reported by multiple Tennessee news outlets. The discrepancy between Berry's international travel and the billing records formed the basis for the fraud charges.
TennCare, Tennessee's Medicaid program, provides healthcare coverage to eligible low-income residents, children, pregnant women, and individuals with disabilities. Federal and state regulations require that healthcare providers bill only for services actually rendered, and fraudulent billing can result in both criminal charges and exclusion from federal healthcare programs.
Charges and Legal Proceedings
Berry was taken into custody and processed at the Shelby County Jail before being released on her own recognizance, according to jail records. The theft charge reflects the estimated value of the fraudulent billings submitted to the state Medicaid program during the four-day period in question.
Each count of TennCare fraud represents a separate alleged billing violation. Under Tennessee law, TennCare fraud is classified as a felony offense, and conviction can result in significant prison time, fines, and mandatory restitution to the defrauded government program.
The case remains under investigation, and additional charges could be filed as authorities continue reviewing billing records and patient documentation, according to the TBI.
Healthcare Fraud Enforcement
Tennessee's Medicaid Fraud Control Division operates as part of the Office of the Attorney General and works in coordination with federal authorities to investigate and prosecute healthcare providers who defraud government insurance programs. The division receives funding from both state and federal sources and has jurisdiction over fraud cases involving TennCare and other publicly funded healthcare programs.
Healthcare fraud schemes can take various forms, including billing for services not rendered, upcoding procedures to receive higher reimbursements, unbundling services that should be billed together, and submitting duplicate claims. Federal regulations require healthcare providers to maintain accurate records documenting all services billed to government programs.
The U.S. Attorney's Office, which referred this case to state investigators, maintains concurrent jurisdiction over Medicaid fraud cases and can pursue federal charges in cases involving interstate commerce or larger-scale fraud schemes.
Professional Licensing Implications
Beyond criminal prosecution, Berry could face disciplinary action from the Tennessee Board of Nursing, which regulates nurse practitioners and other advanced practice nurses in the state. Professional licensing boards maintain separate authority to suspend, revoke, or restrict healthcare licenses based on criminal convictions, fraudulent conduct, or violations of professional standards.
Federal law also requires the exclusion of healthcare providers convicted of certain offenses from participation in Medicare, Medicaid, and other federal healthcare programs. Such exclusions can effectively end a healthcare provider's ability to treat patients covered by government insurance programs.
Impact on Patients and the Healthcare System
TennCare fraud affects both taxpayers who fund the Medicaid program and vulnerable patients who depend on the program for essential healthcare services. Resources diverted through fraudulent billing reduce funding available for legitimate patient care and undermine public confidence in healthcare systems.
Tennessee officials have emphasized the importance of reporting suspected Medicaid fraud to appropriate authorities. The state operates a fraud hotline and online reporting system for individuals who suspect billing irregularities or other forms of healthcare fraud.
Resources for Families
Individuals who suspect healthcare fraud or billing irregularities involving Medicaid programs can contact the Tennessee Bureau of Investigation's Medicaid Fraud Control Division or the U.S. Department of Health and Human Services Office of Inspector General.
The National Long-Term Care Ombudsman Resource Center provides advocacy services for individuals receiving healthcare services and can be reached at 1-800-677-1116. Additional information is available at https://ltcombudsman.org.
Tennessee residents can also report suspected TennCare fraud directly to the Office of the Attorney General through the state's fraud reporting hotline or online complaint system.
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