New Jersey Man Gets 87 Months For Defrauding Traumatic Brain Injury Fund Out Of Millions
U.S. Attorney Philip R. Sellinger announced Thursday that a New Jersey man was sentenced to 87 months in prison for conspiracy to commit healthcare fraud, five acts of healthcare fraud, and four counts of tax evasion.
C.R. Kraus, 58, of Manville, New Jersey was convicted in April 2024 of all 10 counts of an indictment following a trial before U.S. District Judge Zahid N. Quraishi in Trenton federal court. In January 2023, Kraus's conspirators, Harry Pizutelli and Maritza Flores, pleaded guilty to conspiracy to commit healthcare fraud and tax evasion relating to defrauding the New Jersey Traumatic Brain Injury Fund (TBI Fund) of millions of dollars for their benefit. Both are awaiting sentencing.
"This defendant stole millions of dollars earmarked for victims of traumatic brain injuries. Stealing resources intended to help New Jersey residents who are already coping with serious challenges is especially egregious. This office will never relent in holding such criminals accountable. Today, this defendant learned the price of his criminal acts," said U.S. Attorney Philip R. Sellinger.
"C.R. Kraus was intent on defrauding the Traumatic Brain Injury Fund by making false claims that he treated patients who suffer from such maladies," FBI – Newark Acting Special Agent in Charge Nelson I. Delgado said. "This not only took away valuable resources from other deserving patients but enabled Kraus and his co-conspirators to benefit substantial monetary gain, to the tune of more than $4 million. The FBI investigative team worked to put a stop to their fraudulent behavior, and bring to justice criminals who use the healthcare system as a personal piggy bank."
"Motivated entirely by greed, C.R. Kraus and his co-conspirators stole millions of dollars from a government program meant to aid individuals with life-altering injuries," Special Agent in Charge Jenifer L. Piovesan, IRS Criminal Investigation, Newark Field Office, said. "Today's sentence reinforces IRS-CI's dedication to investigating financial crimes and ensuring bad actors are held accountable for their misconduct."
According to documents filed in this case and the evidence at trial:
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. The TBI Fund's purpose is to provide New Jersey residents 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. Services funded by the TBI Fund include 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.
After a prospective patient applies for services, TBI Fund personnel review the application and, if approved, the patient is authorized to secure designated services from a third-party vendor. Once a patient receives services approved by the TBI Fund, the vendor or service provider submits an invoice to the TBI Fund for payment. When an invoice is received, TBI Fund personnel review the invoice to ensure that the patient had been approved to receive the services. If the invoice is approved, an internal payment voucher is generated, authorized by TBI Fund personnel, and then submitted to the New Jersey Department of the Treasury for payment, which issues a check directly to the vendor.
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 beneficiaries. From 2009 through June 2019, Pizutelli, Kraus, and Flores conspired to defraud the TBI Fund by misappropriating more than $4 million in fraudulent vendor payments for purported services that were never actually provided. Pizutelli orchestrated the distribution of fraudulent vendor payments to Flores and Kraus by generating and processing false invoices and internal payment vouchers. Pizutelli generated these invoices and vouchers to give the appearance that Flores and Kraus had provided approved services to eligible patients when, in fact, they had not provided any services. Pizutelli then approved and transmitted the internal payment vouchers so that his conspirators received vendor payments.
Pizutelli orchestrated these fraudulent payments to maintain and further romantic and/or sexual relationships with Flores, including more than $940,000 in fraudulent distributions to Flores and more than $3.245 million in fraudulent distributions to Kraus. To obscure their fraudulent conduct, Flores and Kraus also evaded the payment of 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.
In addition to the prison term, Judge Quraishi sentenced Kraus to three years of supervised release and ordered restitution of $4.19 million.
U.S. Attorney Sellinger credited special agents of the FBI, Newark Division, Red Bank Resident Agency, under the direction of Acting Special Agent in Charge Delgado, and special agents of IRS – Criminal Investigation, under the direction of Acting Special Agent in Charge Jenifer L. Piovesan, with the investigation leading to the guilty verdict. He also thanked the New Jersey Attorney General's Office, Division of Law, and the New Jersey Department of Human Services, for its assistance.
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