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TRENTON
- Attorney General Paula T. Dow and Acting
Insurance Fraud Prosecutor Ronald Chillemi
announced that an Ocean County social worker
was sentenced today for fraudulently billing
insurance companies for services not rendered.
According
to Acting Insurance Fraud Prosecutor Chillemi,
Mary F. Rizzuto, 51, of Toms River, a licensed
clinical social worker, was sentenced to
five years of probation conditioned upon
serving 90 days in county jail by Superior
Court Judge Wendel E. Daniels in Ocean County.
Daniels also ordered Rizzuto to pay $76,304
in restitution. The sentence was based on
Rizzuto’s guilty plea to an accusation
charging her with third-degree theft by
deception. Rizzuto also faces disciplinary
proceedings before the New Jersey Board
of Social Work Examiners concerning her
professional license.
In
pleading guilty on Sept. 12, 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 sentencing. 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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