A Tennessee optometrist has been sentenced to 42 months in federal prison after admitting that she used her Brentwood practice to submit approximately $11 million in false Medicare claims and received about $6.9 million.
Helen Boerman operated Brentwood Eye Care, where prosecutors said she split wound care products intended for single use while billing Medicare as though new products had been purchased and used for each treatment.
Boerman pleaded guilty to one count of making false, fictitious or fraudulent claims. Chief U.S. District Judge William L. Campbell Jr. sentenced her on September 10, according to NewsChannel 5.
The court also imposed one year of supervised release and ordered Boerman to pay $6,970,583.50 in restitution to Medicare, TennCare, the Federal Employees Health Benefits Program and several private insurers. She is scheduled to surrender January 4, 2027, to begin serving her sentence.
Patients Were Billed for Treatment Dates When They Had No Appointment
Federal prosecutors described a May 2022 example involving two Medicare beneficiaries. Brentwood Eye Care submitted claims for wound care products supposedly placed on May 20, 23, 24, 25, 26 and 27.
Appointment data showed that the two patients were actually scheduled at the practice only on May 20, May 24 and May 27. Boerman directed employees to create false records for the other dates to support services that had been fraudulently billed, according to the U.S. Attorney’s Office for the Middle District of Tennessee.
The false records made it appear that additional treatments had occurred and supported reimbursement claims for wound care products prosecutors said had not been newly purchased or used as claimed.
Single-Use Products Were Split Between Treatments
Boerman admitted that she used Brentwood Eye Care to submit false Medicare claims over approximately three and a half years. Instead of using a new wound care product each time, she split products intended for single use and then sought reimbursement as though separate new products had been purchased and used.
Court records described the products as grafts that were supposed to be used once. Boerman split them between treatments while billing Medicare for separate products, allowing the practice to seek reimbursement for supplies it had not actually purchased or used in the manner represented on the claims.
In all, Boerman admitted submitting approximately $11 million in false Medicare claims and receiving about $6.9 million. She also made false claims to TennCare and the Federal Employees Health Benefits Program between March 2020 and October 2024.
The final restitution order includes losses to those government programs as well as several private insurers.
Federal and Tennessee Investigators Worked the Case
The Department of Health and Human Services Office of Inspector General, the Tennessee Bureau of Investigation and the Office of Personnel Management Office of Inspector General investigated Boerman’s conduct.
Assistant U.S. Attorney Sarah Bogni prosecuted the case for the Middle District of Tennessee. Boerman faced a maximum statutory sentence of five years in federal prison on the offense to which she pleaded guilty.
The 42-month sentence was below that maximum. The court allowed Boerman to remain out of custody until January 4, when she is scheduled to surrender and begin serving the prison term.
How Medicare Patients Can Check for False Billing
Medicare advises beneficiaries to compare the dates and services on their claims with their own calendars, receipts and provider statements. Charges for appointments, treatments, medical supplies or equipment a patient does not recognize should be checked rather than assumed to be routine billing.
People with Original Medicare can review claims through a secure Medicare.gov account instead of waiting for a mailed Medicare Summary Notice. The online account allows beneficiaries to see claims after Medicare processes them, including the services or supplies billed and what Medicare paid.
If a charge appears incorrect, Medicare advises patients to contact the provider’s office first to determine whether it is a billing mistake. If the issue cannot be explained or corrected, suspected fraud can be reported to Medicare. Keeping a record of appointment dates and saving receipts and statements can make it easier to compare the care actually received with what was billed.
Suspected Medicare fraud can be reported at 1-800-MEDICARE or through Medicare’s online fraud reporting process. Reports involving fraud against Medicare, Medicaid or other Department of Health and Human Services programs can also be submitted through the HHS Office of Inspector General.