Two individuals from Connecticut were taken into custody on Thursday for their involvement in health care fraud. The alleged scheme targeted the state’s Medicaid program and caused the Department of Social Services to suffer losses exceeding $1.8 million.
Ramon Apellaniz, aged 39, from Middletown, and Suhail Aponte, aged 38, from Wethersfield, recently made an appearance before a U.S. Magistrate Judge in Hartford. This information was stated in a report by the U.S. Attorney for the District of Connecticut.
Aponte was able to secure his release by posting a $100,000 bond. On the other hand, Apellaniz, who goes by the aliases “Kristopher Rockefeller” and “Kris,” remains in custody as his hearing is set for next Thursday.
The Connecticut Department of Social Services administers the Connecticut Medical Assistance Program, which offers medical assistance to individuals with low incomes. These benefits, referred to as “HUSKY” or “Connecticut Medicaid,” are funded by both the state and the federal government.
According to court documents and testimonies, it has been revealed that Apellaniz used to run The Gemini Project, LLC., a counseling business located in Newington. The business aimed to provide support to individuals dealing with mental, behavioral, and emotional disorders. However, it is important to note that Apellaniz does not hold a valid license as a provider, as stated in Connecticut’s public license database.
In 2020, Apellaniz faced charges from the state for larceny, health care fraud, and identity theft offenses. It was alleged that Apellaniz provided services to several Medicaid beneficiaries without being licensed as a provider. Prosecutors claimed that Gemini, the billing entity, submitted claims to Medicaid for these services, including services that were never actually provided.
Gemini and Apellaniz received $909,268 from Medicaid for their fraudulent claims. Apellaniz entered a plea of nolo contendere and was subsequently sentenced to eight years in prison in Hartford Superior Court on April 17, 2024. However, the execution of the sentence was suspended after 15 months, and Apellaniz was placed on five years of parole. On November 19, 2024, Apellaniz was released from prison.
In June 2021, prosecutors claim that an autism specialist group called Minds Cornerstone LLC, also known as Minds Cornerstone Behavior Therapy Services, registered with the state. The operation listed Aponte, who is not a licensed provider, as its manager and registered agent.
In November 2021, Apellaniz, Aponte, and Minds Cornerstone are accused of defrauding the Connecticut Medicaid Program. They allegedly submitted false claims for applied behavior analysis services for children with autism spectrum disorder.
According to prosecutors, Apellaniz is accused of conspiring with Aponte and running Minds Cornerstone, a Medicaid enrollment company, under a false name, despite not being listed on any enrollment forms, having no ownership stake, or signatory authority to the company’s bank accounts. What makes this case even more unusual is that Apellaniz allegedly managed the company while being incarcerated.
Apellaniz and Aponte face federal complaints stating that they billed Medicaid for services that were supposedly provided to patients, despite company payroll records showing that employees were not paid for these services.
Prosecutors claim that the behavioral technician services were not billed with the correct procedure code. Furthermore, it has been alleged that these services were provided to patients who were actually in an impatient hospital. It has also come to light that services were allegedly rendered even though parents of patients and former employees of Minds Cornerstone have since confirmed that these services never took place.
Between November 2021 and December 2024, Apellaniz and Aponte allegedly submitted or caused the submission of false claims to Medicaid. These claims resulted in losses exceeding $1.8 million to the Connecticut Department of Social Services.
Apellaniz is currently under investigation for the alleged misuse of funds. Based on the ongoing investigation, it appears that he used a portion of the funds allocated to Minds Cornerstone to fulfill his restitution obligations from a prior legal case.
From May 2022 to November 2024, Aponte worked for the state in the Office of Policy and Management.
Both individuals face charges of conspiracy to commit health care fraud and health care fraud, with each offense carrying a maximum sentence of 10 years in prison.
