Date: April 19, 2024 Contact: newsroom@ci.irs.gov A Somerset County, New Jersey, man was convicted of conspiracy to commit healthcare fraud, five acts of healthcare fraud, and four counts of tax evasion, U.S. Attorney Philip R. Sellinger announced today. C.R. Kraus, of Manville, New Jersey was convicted 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 own personal benefit. “This defendant was convicted of multiple crimes for his role in a conspiracy that resulted in the theft of millions of dollars earmarked for victims of traumatic brain injuries,” U.S. Attorney Sellinger said. “Stealing resources intended to help New Jersey residents who are already coping with serious challenges is especially egregious. My office, and our law enforcement partners, are always working to root out this kind of criminal activity and ensure the guilty face appropriate punishment.” “People battling to regain their lives after surviving a traumatic brain injury, and then digging out from the astronomical costs of healthcare related to the injury are the victims in this case,” FBI – Newark Special Agent in Charge James E. Dennehy said. “Those people should have been the recipients of money from a fund created specifically to help them, not Kraus and his co-conspirators. I want to commend the outstanding work of the investigators and prosecutors in this investigation who successfully fight each day to seek justice against criminals who believe their crimes may not harm or impact anyone. It does, and they will be held accountable.” 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. The healthcare fraud conspiracy charge and substantive healthcare fraud charges to which Kraus was convicted each carry a maximum penalty of 10 years in prison and a maximum fine of $250,000. The tax evasion charges to which Kraus was convicted each carry a maximum penalty of 10 years in prison and a maximum fine of $250,000. Sentencing is scheduled for Oct. 8, 2024. U.S. Attorney Sellinger credited special agents of IRS - Criminal Investigation, under the direction of Acting Special Agent in Charge Jenifer L. Piovesan, and special agents of the FBI, Newark Division, Red Bank Resident Agency, under the direction of Special Agent in Charge Dennehy, 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 their assistance. The government is represented by Eric A. Boden, Attorney-in-Charge in Trenton, and Assistant U.S. Attorney Eric Suggs of the U.S. Attorney’s Office Trenton Branch Office.
