A Tennessee optometric physician has been ordered to repay $6,970,583.50 after admitting a health-care fraud scheme that billed Medicare and other government programs. The exact restitution amount follows a 42-month federal prison sentence and reflects money received through years of false submissions. The court action is final enough to support “must repay,” rather than describing restitution as a future request.
Repeated Service Dates Made the Billing Pattern Visible
Helen Boerman used Brentwood Eye Care to submit false Medicare claims over roughly three and a half years. The Middle District of Tennessee said some claims listed services on dates when patients had no appointment. In one example, two beneficiaries were billed for wound-care product placement across six dates even though records showed appointments on only three.
Boerman directed staff to create records for the additional dates, according to prosecutors. That made the fraud more than an accidental mismatch between a calendar and a claim. The fabricated documentation was designed to support reimbursement for services that did not occur.
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Single-Use Wound Products Were Split
The government also said Boerman billed for wound-care products she had not purchased or used as represented because products intended for one use were split. Billing a full product while dividing it among uses can make the claim appear tied to a cost the practice never incurred for that patient.
Wound products have become a major enforcement focus because high reimbursement and repeated applications can generate large totals quickly. Here, the conduct extended beyond Medicare: false claims were also submitted to TennCare and the Federal Employees Health Benefits Program from March 2020 through October 2024.
Eleven Million Dollars Was Submitted, $6.9 Million Received
As part of her guilty plea, Boerman admitted submitting approximately $11 million in false claims and receiving approximately $6.9 million. The two figures measure different stages. Submitted claims reflect the attempted billing; received funds show what government programs actually paid.
The restitution order of $6,970,583.50 closely tracks the amount received but is stated exactly in the judgment described by DOJ. It should not be rounded into an assertion that every dollar of the $11 million billed was paid. The court also imposed a $100 special assessment and one year of supervised release after prison.
The Sentence Establishes the Procedural Posture
Chief U.S. District Judge William L. Campbell Jr. imposed the 42-month sentence on September 10. Boerman had pleaded guilty, so the case did not remain at the accusation stage. That allows the article to describe admitted conduct and a repayment obligation without allegation-only qualifiers attached to the core fraud.
Investigators included HHS OIG, the Tennessee Bureau of Investigation and the Office of Personnel Management OIG. Their combined role reflects the fact that the same billing operation reached Medicare, a state Medicaid agency and the federal employee plan.
Beneficiary Statements Can Expose Impossible Dates
A patient does not need to evaluate clinical coding to notice a service listed on a day no visit occurred. Explanations of benefits can show provider names, dates and broad service descriptions even when the government pays the charge. Preserving an appointment calendar beside those statements creates a simple comparison that automated claims systems may not have.
As of September 15, the current official record supports every central figure: a 42-month sentence, roughly $11 million submitted, about $6.9 million received and $6,970,583.50 ordered in restitution.
Wound-care billing can be difficult for a patient to evaluate because product names and units may be unfamiliar. Dates remain more accessible. A statement showing an application on a day without a visit provides a concrete discrepancy that the provider or Medicare can investigate before anyone tries to decode the product code.
Staff-created records were important to the admitted scheme because documentation is supposed to prove that a billed service occurred. When a false note is added after the fact, a claim may survive an initial automated check. Comparing appointment systems, purchase invoices and product inventory can reveal that the supporting record does not match actual operations.
The restitution figure also avoids a common reporting mistake. Approximately $6.9 million describes receipts in rounded terms, while $6,970,583.50 is the court-ordered obligation. The latter should not be rounded down when describing what Boerman must repay, because the judgment supplies an exact amount.
Medicare beneficiaries are not identified as direct recipients of the restitution. The government programs are the financial victims of the false claims. Any patient concern about personal coinsurance or identity misuse would follow a separate review of the individual claim.
TennCare and the federal employee program broaden the admitted conduct beyond the headline’s Medicare focus. They also explain the participation of state and federal investigators outside ordinary Medicare administration. The restitution order resolves the combined government-program loss described at sentencing rather than creating separate public payments for each billed beneficiary.
The Medicare Assistance Not Shown on a Fraud Claim
A provider-fraud judgment protects public funds, but it does not show whether a beneficiary has applied for premium or drug-cost assistance. Medicare Savings Programs and Extra Help run through separate enrollment systems.
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AI tools assisted in researching and drafting this article, which was reviewed prior to publication.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
