Editor’s Corner: A fraud scheme in a league of its own


http://www.fiercehealthcare.com/antifraud/editor-s-corner-a-fraud-scheme-a-league-its-own?utm_medium=nl&utm_source=internal&mkt_tok=eyJpIjoiT1RWa01EQmxZV1l6WkdGbSIsInQiOiJnVitHTEdcL0c4M1JSOENxdGk2V0Q5U0ZQc3V6TFFDdEg4Y1VUWllWbVE3aVNwU2Y3QUpZdmE5aEE3ZEVRWGMyVk14V0YyUHR5MEZvMDByck9wVmFqXC9ib3pRZnNyb0lmM05sZXl1eVZJRjhBPSJ9

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Earlier this month, authorities arrested Christopher Bathum, the self-described “rehab mogul” and founder of more than two dozen sober homes and outpatient drug treatment facilities in California and Colorado. Bathum was charged with fraudulently billing four different insurance companies more than $176 million.

According to a release by California Insurance Commissioner Dave Jones, Bathum, the CEO of Community Recovery of Los Angeles (CRLA), and Kirsten Wallace, the company’s CFO, lured drug addicts to CRLA facilities, stole patient information in order to purchase health insurance policies without their consent, and then billed insurers for drug treatment services beyond what was provided.

Anthem Blue Cross Blue Shield, Cigna, Health Net and Humana paid the company $44 million before discovering the scheme. Bathum profited handsomely.

But the 50-count fraud complaint (PDF) against Bathum paled in comparison to the allegations contained in a separate lawsuit filed by the Los Angeles County District Attorney’s Office. In that suit, Bathum was charged with sexually assaulting and raping female patients between 2013 and 2016, even going as far as to coerce recovering addicts with drugs.

The allegations against Bathum—who has pleaded not guilty to all charges—are a culmination of nearly a year’s worth of negative press for the rehab mogul. In December, LA Weekly wrote a lengthy feature on Bathum that included allegations from one former patient claiming Bathum sexually assaulted her. At that point, Bathum was also being investigated by city and state law enforcement agencies, along with “nearly every large insurance company in California,” according to LA Weekly.

Three more women have come forward since then, filing civil lawsuits accusing Bathum of sexual assault. In June, Bathum was the target of an hourlong 20/20 investigation that focused primarily on his relationship with several female patients. One woman described how Bathum sexually assaulted her in a cramped sweat lodge at a Malibu sober home. Another said Bathum took her to a seedy Malibu hotel where he overdosed on meth and heroin.

In both the LA Weekly story and the 20/20 special, Bathum repeatedly and categorically denied all of the allegations against him, including any insinuation that he had sexually assaulted female patients or used drugs. He blamed identity theft for the ambulance records linking him to an overdose. At one point he filed a libel lawsuit against LA Weekly’s parent company, which he later withdrew.

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