Wethersfield Man Accused Of Defrauding CT's HUSKY Insurance Program

WETHERSFIELD, CT — Two men are facing federal charges related to defrauding Connecticut’s Medicaid program, including a resident of Wethersfield.

Ramon Apellaniz, also known as "Kristopher Rockefeller" and "Kris," a 39, resident of Middletown; and Suhail Aponte, 38, of Wethersfield, were arrested yesterday on federal criminal complaints charging each with health care fraud offenses stemming from a scheme that defrauded Connecticut’s Medicaid program, authorities said.

Making the announcement were Vanessa Roberts Avery, United States attorney for the District of Connecticut; Robert Fuller, special agent in charge of the New Haven Division of the Federal Bureau of Investigation; Roberto Coviello, special agent in charge of the U.S. Department of Health and Human Services, Office of the Inspector General; and Chief State’s Attorney Patrick J. Griffin

Apellaniz and Aponte appeared before U.S. Magistrate Judge Thomas O. Farrish in Hartford. Aponte was released on a $100,000 bond and Apellaniz was detained pending a hearing that is scheduled for Jan. 23, Avery said.

The Connecticut Medical Assistance Program is a Connecticut Department of Social Services-administered program that provides medical assistance to low income persons. CTMAP's benefit packages, referred to as "HUSKY" or "Connecticut Medicaid," are jointly funded by the State of Connecticut and the federal government.

According to case records, Apellaniz previously operated The Gemini Project LLC, a Newington-based business that offered counseling to patients with mental, behavioral, and emotional disorders. According to the Connecticut public license database, Apellaniz is not a licensed provider.

In 2020, Apellaniz was charged by the state with larceny, health care fraud, and identity theft offenses related to his providing services to numerous Medicaid beneficiaries as a non-licensed provider, and Gemini billing Medicaid for those services, or for services that were not rendered at all, according to case records.

Medicaid paid Gemini and Apellaniz $909,268 for the false claims, according to case records.

Apellaniz pleaded nolo contendere or "no contest" and, on April 17, 2024, was sentenced in Hartford Superior Court to eight years in prison, execution suspended after 15 months, and five years of parole. He was released from Department of Correction custody on Nov. 19 of this year, case records show.

According to case records, in June 2021, Minds Cornerstone LLC, doing business as Minds Cornerstone Behavior Therapy Services, an Autism Specialist Group, was registered with the State of Connecticut. Aponte, who is not a licensed provider, was listed as its manager and registered agent, Avery said.

Beginning in approximately November 2021, Apellaniz, Aponte, and Minds Cornerstone defrauded the Connecticut Medicaid Program by submitting fraudulent claims for applied behavior analysis services to children diagnosed with Autism Spectrum Disorder, according to case records. Although Apellaniz does not appear on any of Minds Cornerstone’s Medicaid enrollment forms, has no ownership interest in the company, and has no signatory authority to any of its bank accounts, Apellaniz conspired with Aponte and ran the company under a pseudonym, including while he was incarcerated in state custody, according to case records.

The complaint specifically charges that Apellaniz and Aponte billed Medicaid for services purportedly rendered to patients when company payroll records indicate employees were not compensated for the associated services; direct supervision services purportedly provided by a Board Certified Behavior Analyst of a behavioral technician, when the corresponding procedure code for behavioral technician services was not billed; services purportedly rendered to patients who were actually in an inpatient hospital; and services purportedly rendered when parents of patients and former employees of Minds Cornerstone confirmed those services did not occur.

It is charged that, between November 2021 and December 2024, Apellaniz and Aponte submitted or caused to be submitted to Medicaid fraudulent claims that exceeded $1.8 million in losses to the Connecticut Department of Social Services. The ongoing investigation indicates that Apellaniz used some of the funds Minds Cornerstone received to pay a portion of the restitution he owes as a result of his state prosecution, according to case records.

From approximately May 2022 until November of this year, Aponte was also employed by the State of Connecticut in the Office of Policy and Management, Avery said.

Apellaniz and Aponte are charged with conspiracy to commit health care fraud, and health care fraud. Each offense carries a maximum 10-year prison term, Avery said.