Tennessee Doctor Accused of $6.9 Million Medicare Fraud Through Optometry Practice

A Tennessee optometrist has pleaded guilty to orchestrating a massive Medicare fraud scheme that bilked the federal healthcare program out of nearly $7 million over three and a half years.

Helen Boerman, 48, admitted to systematically filing false claims through her practice, Brentwood Eye Care, according to the U.S. Attorney’s Office for the Middle District of Tennessee. The scheme involved billing Medicare for wound care products that were never purchased or used, while splitting single-use wound care products across multiple patients.

Federal prosecutors detailed how Boerman’s fraud operation worked, citing a specific example from May 2022. During that month, she submitted Medicare claims for wound care treatments allegedly provided to two patients on six different days. In reality, these patients had only visited her practice on three of those dates. To cover her tracks, Boerman instructed her staff to create falsified medical records documenting the non-existent appointments.

“This case demonstrates our commitment to investigate fraud, find those responsible, and hold them accountable with jail sentences,” said United States Attorney Braden Boucek. “We will not tolerate fraud against the taxpayers here in the Middle District of Tennessee.”

The investigation revealed that Boerman’s fraudulent activities extended beyond Medicare. She also submitted false claims to TennCare, Tennessee’s Medicaid program, and the Federal Employees Health Benefits Programs between March 2020 and October 2024. While the total Medicare claims submitted reached approximately $11 million, Boerman successfully received payments totaling $6.9 million before authorities caught up with her operations.

Healthcare fraud has become an increasingly serious concern for federal authorities in recent years. According to the Department of Health and Human Services, Medicare fraud alone costs American taxpayers tens of billions of dollars annually. The Centers for Medicare & Medicaid Services estimates that improper payments across all healthcare programs exceed $100 billion each year.

The Boerman case is particularly notable for involving an optometry practice. While much healthcare fraud enforcement has traditionally focused on areas like pain management clinics and durable medical equipment providers, this case highlights how fraud can permeate virtually any medical specialty.

The successful prosecution resulted from a coordinated investigation involving multiple agencies, including the U.S. 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.

Healthcare fraud typically carries significant penalties under federal law. Offenders face not only substantial prison sentences but also mandatory restitution payments, civil monetary penalties, and potential exclusion from participation in federal healthcare programs. While sentencing details for Boerman were not immediately available, similar cases have resulted in multi-year prison terms.

For patients of Brentwood Eye Care, the case raises questions about the integrity of their medical records and treatment. When providers falsify medical documentation, it can potentially impact patient care by creating inaccurate health histories that might mislead future healthcare providers.

The case also underscores the importance of Medicare’s ongoing efforts to strengthen its fraud detection systems. In recent years, the program has increasingly turned to data analytics and artificial intelligence to identify suspicious billing patterns before large-scale losses occur.

As Medicare spending continues to grow with America’s aging population, authorities have emphasized that combating fraud remains a top priority. The Department of Justice has consistently ranked healthcare fraud among its most significant white-collar crime concerns, with dedicated task forces operating in major metropolitan areas nationwide.

The Boerman case serves as a reminder that healthcare fraud investigations often require patience and persistence. The scheme operated for over three years before authorities were able to gather sufficient evidence for prosecution, highlighting both the sophisticated nature of some healthcare fraud operations and the determination of investigators to unravel them.