A Tennessee health-care executive has been ordered to pay $6,970,583.50 in restitution after years of false billing to Medicare and other government programs. Federal prosecutors say the companies submitted roughly $11 million in false claims and received about $6.9 million. The judgment follows a guilty plea and a 42-month prison sentence, so the case has moved beyond accusation into final criminal accountability.

Testing companies billed federal programs for false claims

Helen Boerman owned and operated two diagnostic-testing companies. Prosecutors said the businesses provided electrodiagnostic and ultrasound testing while submitting claims that misrepresented the services, the people performing them or the medical circumstances supporting payment.

The charged conduct ran over several years and reached Medicare, Medicaid and TRICARE. Those programs use different funding and eligibility structures, but they share a reliance on provider claims that accurately identify the service and meet coverage rules.

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The sentence separates billed claims from money received

The U.S. Attorney’s Office for the Middle District of Tennessee reported that the companies submitted approximately $11 million in false claims and received about $6.9 million. That difference matters: the larger figure describes attempted billing, while the smaller figure is closer to the money actually paid by the programs.

Chief U.S. District Judge William L. Campbell Jr. imposed a 42-month prison sentence on September 10, followed by one year of supervised release. Boerman was ordered to pay $6,970,583.50 in restitution and a $100 special assessment. The Justice Department announced the sentence on September 14.

Restitution seeks to compensate the programs for loss caused by the offense. It is distinct from the prison term and from any administrative exclusion that may limit future participation in federal health programs. The exact restitution figure in the judgment is more precise than the rounded amount used in the government’s general description of the scheme.

False claims consume money without changing patient eligibility

Medicare fraud cases often involve program dollars rather than direct theft from a beneficiary’s checking account. That does not make the household consequence abstract. Medicare Part B financing combines beneficiary premiums with federal revenue, so improper provider payments draw from a system funded by older households and taxpayers.

The Centers for Medicare and Medicaid Services’ Center for Program Integrity coordinates efforts to prevent and detect fraud across Medicare and Medicaid. Its work includes data analysis, provider oversight and partnerships with law-enforcement agencies.

Beneficiaries may encounter false billing through a Medicare Summary Notice listing services that never occurred or were different from what was delivered. Medicare’s reporting guidance directs suspected fraud to the appropriate program channels. A report is a lead, not a declaration that a provider committed a crime.

Collection determines how much restitution ultimately returns

A restitution order fixes what the defendant owes, but it does not prove that the full amount has already been collected. Federal collection can involve payment schedules, liens and available assets. The defendant’s resources and other legal obligations shape the pace of recovery.

The press release does not announce a consumer claim fund. Medicare beneficiaries do not receive individual payments from this criminal judgment merely because program funds were misused. The recovery belongs to the injured government programs under the court order.

The special assessment is another separate component of the sentence. At $100, it is a statutory criminal assessment rather than a measure of program loss. It should not be added to the restitution figure when describing what the court ordered repaid to the health programs.

The roughly $11 million submitted also should not be called the amount stolen. Claims can be rejected, adjusted or never paid. Prosecutors used about $6.9 million to describe what the government programs actually paid, and the judgment’s $6,970,583.50 figure supplies the exact restitution obligation.

Diagnostic-testing cases can be difficult for patients to spot because a real test may have occurred. The discrepancy may lie in who performed it, what code was used or whether the claim represented the service accurately. A benefit notice and provider record can therefore disagree even when the patient remembers the appointment.

Program-integrity enforcement operates alongside ordinary coverage appeals. A beneficiary disputing personal liability follows Medicare’s claim and appeal process; prosecutors pursue criminal conduct on behalf of the government. The sentence does not replace an individual appeal deadline or resolve every patient statement generated during the scheme.

The one-year supervised-release term begins after imprisonment and keeps the defendant under federal court conditions. It is part of the sentence, but it does not increase or reduce the exact restitution amount.

The Justice Department page remained available when checked September 15, 2026. It supports the roughly $11 million in false claims, about $6.9 million paid, the 42-month sentence and the exact $6,970,583.50 restitution order. The verified record therefore supports “must repay” as a court-imposed obligation while stopping short of suggesting that collection is already complete.

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Medicare Assistance Beyond Fraud Recovery

A criminal judgment restores program funds, but it does not enroll households in other public assistance. Medicare Savings Programs, SSI after 65 and unclaimed property use separate applications, searches and income rules.

The 69-page guide covers 11 programs and includes the 2026 income limits plus a 50-state phone directory.

Compare the assistance programs in The Benefits Checklist.

This article was produced with AI assistance and reviewed by a human editor.