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The Times of India
The Times of India
World
TOI World Desk

Tennessee woman pleads guilty to $6.9 million Medicare fraud through false billing over three years

A Tennessee optometrist has pleaded guilty to a multimillion-dollar healthcare fraud scheme that federal prosecutors say cheated Medicare and other government programs out of millions of dollars over several years.

48-year-old Helen Boerman of Brentwood admitted earlier this week that she defrauded Medicare of approximately $6.9 million through false billing tied to her eye care practice, Brentwood Eye Care.

“Eliminating fraud in federal programs and holding fraudsters accountable is among the highest priorities of the Department of Justice,” said United States Attorney Braden Boucek.

He added: “This case demonstrates our commitment to investigate fraud, find those responsible, and hold them accountable with jail sentences. We will not tolerate fraud against the taxpayers here in the Middle District of Tennessee.”

According to court documents, Boerman used her practice over a period of about three-and-a-half years to submit false claims to Medicare. Prosecutors said she billed for wound care treatments that were not actually provided, in part by splitting single-use medical products and creating false documentation to justify additional charges.

In one example cited in court filings, Boerman allegedly submitted claims for multiple days of treatment for two patients even though records showed they only attended appointments on three of those days. She then directed staff to create false records to match the billing submissions. The scheme extended beyond Medicare, with Boerman submitting false claims to TennCare, Tennessee’s Medicaid programme, and the Federal Employees Health Benefits Program between March 2020 and October 2024.

Boerman admitted that she submitted around $11 million in false claims in total, receiving approximately $6.9 million in payments.

She will be sentenced on September 10, 2026 and faces a maximum penalty of five years in federal prison.

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