In one of the biggest insurance fraud cases in Californian history, Kirsten Wallace of Coffs Harbour, Australia has been charged. She is facing up to 53 years in state prision for allegedly defrauding health insurers of a whopping $176 million. As reported by Dan Proudman last week in The Sydney Morning Herald, the fraud charges convert to over $233 million in Australian dollars.

Wallace, who was arrested earlier this month, has been living in the United States for about ten years, but has lived here before. As Proudman explains, in 1999, she moved back to Australia after her first stay in order to be near her mother. She relocated to California with her daughter seven years later.

Wallace is charged with conducting her fraudulent activities while working as the chief financial officer of the Community Recovery company in the State of California. The organization, which is owned by Chris Bathum, runs approximately 20 rehabilitation centers including six in Colorado and 13 drug and alcohol rehabilitation facilities in Los Angeles. He too, is also being investigated for what is being called “an elaborate conspiracy” to defraud both patients seeking treatment and their insurance companies.

The charges are both vast and disturbing. Proudman points out that among them are sexual assault of patients, stealing patient identities, buying health insurance policies for patients without their knowledge and continuing to bill insurance companies for treatments after the services were completed. Charges also include grand theft, by way of falsely representing Community Recovery as a residential treatment facility.

Dave Jones is the California Insurance Commissioner. Needless to say, he is disgusted with the actions of the accused. “Bathum and Wallace’s alleged conspiracy victimised hundreds of people addicted to drugs and alcohol by keeping them in a never-ending cycle of treatment, addiction and fraud – all the while lining their pockets with millions of dollars from allegedly fraudulent insurance claims,” Proudman quotes him as saying.

It bears repeating that the duo is being charged with one of the biggest health insurance fraud cases in Californian history. And, as a result, they are facing one of the stiffest prison sentences we’ve ever heard of. It cannot be stressed enough how hurtful a crime health insurance fraud really is. And it’s the reason why the team of clinical experts, here at Allegiant Experts, remains so dedicated to diminishing health care fraud in our country.

We are committed to assisting attorneys with their litigations against those who commit health insurance fraud. For more information about our experience, expertise and how we may be able help your case, please don’t hesitate to contact us at 407-217-5831.