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TRENTON
- Attorney General Paula T. Dow and Division
of Criminal Justice Director Stephen J.
Taylor announced that an Ocean County social
worker has pleaded guilty to fraudulently
billing insurance companies for services
not rendered.
According
to Acting Insurance Fraud Prosecutor Ronald
Chillemi, Mary F. Rizzuto of Toms River,
51, a licensed clinical social worker, pleaded
guilty yesterday (Sept. 12) to an accusation
charging her with third-degree theft by
deception. The plea was taken by Superior
Court Judge Wendel E. Daniels in Ocean County.
Judge
Daniels scheduled sentencing for Nov. 4.
Under the plea agreement, Rizzuto will pay
$76,304 in restitution and the state will
recommend that she be sentenced to five
years probation conditioned upon serving
90 days in county jail. Rizzuto also faces
disciplinary proceedings before the New
Jersey Board of Social Work Examiners concerning
her professional license.
At
the guilty plea hearing, Rizzuto admitted
that between Jan. 3, 2003 and Nov. 22, 2008,
she fraudulently obtained money from Horizon
Blue Cross Blue Shield of New Jersey and
Guardian Life Insurance Company by submitting
claims for professional services purportedly
provided to insured individuals. However,
Rizzuto had not provided the services and
was, therefore, not entitled to compensation.
The
investigation began after one of Rizzuto’s
former clients received an Explanation of
Benefits document from his health care insurance
company indicating that Rizzuto had submitted
claims for payment for more than twenty
counseling sessions that had not taken place.
Detective
Natalie Brotherston and Deputy Attorney
General Geraldine D. Zidow were assigned
to the investigation. Zidow represented
the Office of the Insurance Fraud Prosecutor
at the guilty plea hearing. Acting Insurance
Fraud Prosecutor Chillemi thanked Horizon
Blue Cross Blue Shield of New Jersey and
Guardian Life Insurance Company for their
assistance in the investigation.
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