New Jersey TBI Fund Manager Confessed to Committing Illegal Healthcare Fraud Conspiracy

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Romance and healthcare fraud end up together in prison. Harry Pizutelli, 64, and his co-conspirators confessed to defrauding the Traumatic Brain Injury Fund (TBI Fund), a publicly funded healthcare program. Pizutelli’s lover named Maritza Flores, 45, and C.R. Kraus were also charged with conspiracy to commit healthcare fraud for stealing millions of dollars from the program. Pizutelli and Flores admitted their involvement in the scheme while they were dating. The three of them profited illegally from false payments for a decade from 2019 to 2019.

The New Jersey Traumatic Brain Injury Fund is a program that operates under the New Jersey Division of Disability Services which is linked to the New Jersey Department of Human Services. The TBI Fund supports New Jersey residents who suffered a traumatic brain injury and provides assistance by maximizing the quality of life for beneficiaries when other means could not secure their needs. Personnel will review applications submitted to TBI Fund and the beneficiaries could avail of approved services from a third-party provider. When a patient receives the services, the designated service provider would submit invoice receipts to TBI Fund to gain payments. Some of the services covered by the TBI fund for patients include physical, occupational, and speech therapy, neuropsychological services, and general home management and maintenance. The TBI Fund reviews the submitted invoice to verify that it has been availed by the patient and an internal payment voucher is rendered to the New Jersey Department of the Treasury for payment for payment to the third-party provider.

Pizutelli served as a manager of TBI Fund but he used his position to participate in an illegal scheme in which he fabricated invoices and vouchers. The fake claims made it appear that Flores, Kraus, and other c0-conspirators provided services to patients that never occurred in reality. In addition to faking invoices, Pizutelli approved and put out the internal payment vouchers as well. Court documents further divulged that Pizutelli was motivated to commit the crime because he was involved in a romantic or sexual affair with Flores and the other conspirators. The fraudulent payments amounted to more than $4.5 million from the TBI Fund to the conspirators which include distributions worth $940,000 and $3.245 million sent to Flores and Kraus respectively. Likewise, a sum worth $400,000 was distributed to other women who were romantically pursued by Pizutelli. Besides that, Kraus and Flores were charged with tax evasion for their material misstatements on their income tax return and underreporting the income they gained from the healthcare fraud scheme.

Pizutelli and Flores pleaded guilty to charges of conspiracy to commit healthcare fraud and their sentencing will be set on May 8 and 9 in 2023 respectively. The charges

filed against Kraus are pending and remain mere accusations. Although their prison sentences are not yet determined, Pizutelli and Flores face a maximum of ten years in federal prison and a maximum fine of $250,000; and this is twice the amount on gross receipts made by the defendants or gross losses of the victims, depending on which side is greater. The tax evasion charge filed against Flores will cost her to spend a maximum of 10 years in prison and a maximum fine of $250,000.

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