Ramon Apellaniz previously operated The Gemini Project, LLC (“Gemini”), a business that offered counseling to patients with mental, behavioral, and emotional disorders…even though Apellaniz was not a licensed provider. A fact that he withheld from his clients and the Department of Health and Human Services. But in January 2020, with almost $1 million fraudulent Medicaid claims reimbursed, Apellaniz was charged by the state of Connecticut with larceny, healthcare fraud, and identity theft offenses. In April 2024, he pleaded guilty whereupon he was sentenced to prison. All this occurred while he began and executed another Medicaid scheme that was not discovered until well after he was released from prison on parole.
Suhail Aponte was the sole principal and registered agent of Minds Cornerstone LLC, an autism specialist group. Like Apellaniz, Aponte was also not a licensed provider. But this did not deter Apellaniz and Aponte from fraudulently submitting millions of dollars in fraudulent Medicaid claims for applied behavior analysis (“ABA”) services for children diagnosed with Autism Spectrum Disorder (“ASD”). The scheme involved billing Medicaid for services purportedly rendered to patients when Mind Cornerstone employees weren’t on payroll or for services never rendered regardless of what employee was available!
Between November 2021, shortly after being arrested for his first Medicaid fraud, and January 2025, shortly after being released from prison, Apellaniz and Aponte submitted or caused to be submitted to Medicaid fraudulent claims that resulted in a loss of approximately $1,876,617 to the Connecticut Department of Social Services. A portion of those fraudulently gained funds were actually used by Apellaniz to pay restitution for his prior scheme.
One May 16, 2025, Apellaniz pleaded guilty to conspiracy to commit health care fraud. Although, Appelaniz claims he spent more than $500,000 serving the patients, so is asking the judge to reimburse the supposed expenses by not demanding financial restitution.
Excellent job by the F.B.I. in this case.
Today’s Fraud of The Day is based on article “Connecticut man pleads guilty to a second Medicaid fraud, this time for $1.8 million” published by The Middletown Press on May 16, 2025.
A man who has served state prison time for defrauding Connecticut’s Medicaid program of more than $909,000 pleaded guilty in federal court Friday to a separate Medicaid fraud that cost the joint federal-state program more than $1.8 million, federal authorities say.
Ramon Apellaniz, 40, of Middletown, who formerly lived in East Hartford and has also used the names “Kris” and “Kristopher Rockefeller,” pleaded guilty in U.S. District Court in Bridgeport to conspiracy to commit health care fraud, U.S. Attorney for the District of Connecticut David X. Sullivan said in a news release.