U.S. Attorney Philip R. Sellinger said an Edison man, the former manager of the New Jersey Traumatic Brain Injury Fund, acknowledged to a long-running plot to defraud the fund of more than $4.5 million for his own gain.
Harry Pizutelli, 64, pled guilty by videoconference before U.S. District Judge Zahid N. Quraishi in Trenton to one count of conspiracy to commit healthcare fraud on Jan.
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4, according to a press statement from the US Attorney District of New Jersey.
According to the press release, Toms River resident Maritza Flores, 45, also pled guilty to conspiracy to conduct healthcare fraud and tax evasion.
Pizutelli, Flores, and C.R. Kraus were charged with conspiracy to commit healthcare fraud in January 2021 for defrauding the Traumatic Brain Injury (TBI) Fund of millions of dollars for their own profit. The press release states Kraus’ charges are pending.
According to Court Documents and Statements:
The New Jersey Division of Disability Services, part of the Department of Human Services, manages the TBI Fund with public funds. The TBI Fund helps New Jersey citizens with traumatic brain injuries enhance their quality of life when insurance, personal resources, or other programs cannot.
The TBI Fund funds physical, occupational, and speech therapy; service coordination; assistive technology; cognitive therapy; neuropsychological services; medications; wheelchair ramp installation and other home modifications; and home management and upkeep.
TBI Fund staff examine applications for services and authorize third-party vendors to provide them if accepted. After a patient obtains TBI Fund-approved services, the vendor or service provider invoices the fund. TBI Fund staff verify invoices to confirm patients were approved for services.
If the invoice is approved, an internal payment voucher is generated, authorized by TBI Fund staff, and submitted to the New Jersey Department of the Treasury, which issues a check directly to the vendor.
Pizutelli managed the TBI Fund daily.
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He coordinated third-party vendor payments for TBI Fund patients. According to the press statement, Pizutelli, Kraus, Flores, and others conspired to defraud the TBI Fund by misappropriating over $4.5 million in vendor payments for services that were never supplied from 2009 to June 2019.
Pizutelli created and processed fake invoices and internal payment vouchers to pay Flores, Kraus, and others. Pizutelli created these invoices and vouchers to falsely claim that Flores, Kraus, and other conspirators had provided approved services to eligible patients.
According to the news announcement, Pizutelli approved and sent internal payment vouchers.
Pizutelli made these false payments to continue the love and sexual ties with Flores and other collaborators. Pizutelli fraudulently distributed about $4.5 million from the TBI Fund to conspiracy members, including $940,000 to Flores and $3.245 million to Kraus, for their own personal gain.
According to the press release, Flores and Kraus evaded considerable income taxes by making key misstatements and omissions on their federal income tax filings and severely underreporting their fraudulent scheme income.
Pizutelli and Flores each pleaded guilty to healthcare fraud conspiracy, which carries a possible sentence of 10 years in prison and a maximum fine of $250,000 or double the defendants’ gross earnings or victims’ gross loss, whichever is greater. Flores pleaded guilty to tax evasion, which carries a 10-year prison sentence and a $250,000 fine. Pizutelli will be sentenced on May 8, and Flores on May 9.
Sellinger commended the FBI, Newark Division, Red Bank Resident Agency, under Special Agent in Charge James E. Dennehy, and IRS Criminal Investigation, under Special Agent in Charge Tammy L. Tomlins, for the investigation that led to the charges.
He commended the New Jersey Attorney General’s Office Division of Law and the Department of Human Services for their help.