$7M in Medicare fraud results in prison term for eye doctor

An optometric physician in Tennessee has been sentenced to three and a half years in prison after pleading guilty to healthcare fraud, with authorities saying she scammed Medicare and other government healthcare programs out of nearly $7 million.

In a statement, the U.S. Department of Justice (DOJ) said Helen Boerman, 48, will also be ordered to pay back the entire amount in restitution, along with a $100 special assessment fee. 

The agency said her scheme lasted for over three years, during which time Boerman submitted false patient care claims to payers through a clinic she owned, Brentwood Eye Care. To earn illegitimate reimbursement, Boerman instructed staff to create false records in some instances, in an effort to show patients showed up for appointments and received care that was never actually delivered.

In an example highlighted by the DOJ from May 2022, two Medicare beneficiaries were said to be in need of wound care products, but the dates of care delivery submitted to the Centers for Medicare & Medicaid Services did not match dates of appointments that Brentwood had on record.

For example, in May 2022, Boerman, through Brentwood Eye Care, submitted Medicare claims on behalf of two patients on May 20, 23, 24, 25, 26, and 27, even though appointment records showed the patients had appointments only on May 20, 24, and 27. Boerman directed Brentwood Eye Care staff to create false records for the other dates to support services fraudulently billed to Medicare.

Those claims were paid out, until authorities caught on to an overall issue of fraud associated with Brentwood Eye Care and Boerman. The DOJ said the totality of the scam occurred from March 2020 to Oct. 2024

“Health care fraud is theft from American taxpayers and from programs intended to serve people who need them,” U.S. Attorney Braden H. Boucek said. “This defendant exploited those programs for millions of dollars through years of fraudulent billing.”