Personal Injury Firm
Federal authorities reportedly arrested three people accused of planning to defraud the New Jersey Traumatic Brain Injury Fund. The fund’s manager, Harry Pizutelli, and two NJ residents, C.R. Kraus and Maritza Flores, allegedly conspired to defraud the fund by misappropriating more than $4.5 million in fake payments. The investigation into the alleged fraud was conducted by agents from the FBI and the IRS’s Criminal Investigation division.
According to authorities, the money went to pay false invoices and vouchers generated by the three. They also said that Pizutelli created said vouchers to enable personal relationships with Flores and other conspirators.
The frauded institution, the TBI Fund, is a publicly funded program run by the New Jersey Division of Disability Services, a component of the New Jersey Department of Human Services. It’s purpose is to provide residents of the state who have suffered a traumatic brain injury with services and support in order to maximize their quality of life when funding from insurance, personal resources, or other programs is unavailable to meet their needs.
Brain injuries are extremely serious and will always require immediate medical attention. Even a minor concussion can lead to permanent cognitive and behavioral issues. The most serious brain injuries can result in permanent physical disability, paralysis, and even death. According to data quoted by Statista, there were 61,131 cases of traumatic brain injury-related deaths in the US in 2017. And about 2% of the American population — or approximately 5.3 million people — require lifelong assistance with daily tasks because of a traumatic brain injury.
Among the resources the TBI Fund provides includes 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. It also supports those who don’t have insurance or other means to pay for the services.
Per a press release by U.S. Attorney Rachael A. Honig, “Pizutelli was the manager of the TBI Fund and was responsible for its day-to-day operation. He supervised, managed, and oversaw the process by which third-party vendors were paid for services rendered to eligible TBI Fund patients. From 2009 through June 2019, Pizutelli, Kraus, Flores, and others conspired to defraud the TBI Fund by misappropriating more than $4.5 million in fraudulent vendor payments for purported services that were never actually provided.”
Kraus and Flores used the bulk of the $4.5 million defrauded from the fund for their personal benefit. They were reportedly involved romantically. Kraus is reportedly accused of receiving $3.25 million for home modifications that were never done. Flores, who lived with Kraus, received $940,000 for therapeutic services, including occupational and physical therapy and acupuncture, that no one at her Serenity’s Gate business was licensed to perform. They’re also both accused of lying on their tax returns by underreporting income gained from the fraud scheme.
The health care fraud conspiracy charge against the three carries a maximum prison term of 20 years and fines for up to $250,000, or twice the loss sustained by the victim, which could potentially involve millions. The charges and allegations contained in the complaint are accusations and the defendants are presumed innocent unless and until proven guilty.