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Harry Pizutelli, 64, of Edison, pleaded guilty by videoconference to conspiring to commit health care fraud before a federal judge in Trenton, U.S. Attorney Philip R. Sellinger announced on Wednesday, Jan. 4.
One of the women who benefitted from the scheme, Maritza Flores, 45, of Toms River, pleaded guilty to the same charge, as well as to tax evasion, Sellinger said.
In exchange, Pizutelli had amorous congress with her and other partners willing to be similarly enriched, the U.S. attorney said.
Pizutelli was managing the publicly funded New Jersey Traumatic Brain Injury health care benefit program when he hatched the plan with Flores and co-defendant C.R. Kraus, Sellinger said.
Run by the New Jersey Department of Human Services’ Division of Disability Services, the TBI fund provides services and support to New Jersey residents with traumatic brain injuries “when funding from insurance, personal resources or other programs [cannot] meet their needs,” the U.S. attorney said.
It pays for physical, occupational, and speech therapy; service coordination; assistive technology; cognitive therapy; neuropsychological services; pharmaceuticals; wheelchair ramp installation and other home modifications; and general home management and maintenance, he said.
Patients approved for funding are authorized to secure the services they need from third-party vendors who submit invoices and ultimately receive a check from the state Department of the Treasury, Sellinger said.
Pizutelli -- who “supervised, managed, and oversaw” the third-party payment process – plotted with Flores, Kraus and others for a decade, beginning in 2009, to pocket $4.5 million in bogus payments, federal authorities charged.
Pizutelli got his gal pals the money by pumping out phony invoices and vouchers that made it look as though they'd actually provided the appropriate services, a complaint on file in U.S. District Court in Trenton says.
He ”orchestrated these fraudulent payments," Sellinger said, in order to "maintain and further romantic and/or sexual relationships with Flores and other conspirators."
Flores reportedly got $940,000, but that was piddling compared to the $3.245 million that federal investigators said Kraus collected. Both women used the dough for their own purposes, the federal complaint alleges.
Flores and Kraus also “evaded the payment of a substantial amount of income taxes by making material misstatements and omissions on their federal income tax returns and significantly underreporting the income they had derived from the fraudulent scheme,” Sellinger said.
U.S. District Judge Zahid N. Quraishi scheduled back-to-back sentencings for Pizutelli on May 8 and Flores on May 9.
Sellinger, meanwhile, credited special agents of the FBI Newark Division’s Red Bank Resident Agency and IRS Criminal Investigation with the investigation leading to the pleas, secured by J. Brendan Day, who’s the deputy chief of his Criminal Division in Newark, and Assistant U.S. Attorney Eric Suggs of his Trenton Branch Office.
The U.S. attorney also thanked the New Jersey Attorney General’s Division of Law and the state Department of Human Services for their assistance.
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