Source: Federal Bureau of Investigation (FBI) State Crime News
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 today announced that RAMON APELLANIZ, also known as “Kristopher Rockefeller” and “Kris,” 39, of Middletown, and SUHAIL APONTE, 38, of Wethersfield, were arrested yesterday on federal criminal complaints charging each with health care fraud offenses stemming from an alleged scheme that defrauded Connecticut’s Medicaid program.
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 January 23.
The Connecticut Medical Assistance Program (CTMAP) 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.
As alleged in court documents and statements made in court, Apellaniz previously operated The Gemini Project, LLC (“Gemini”), a Newington-based business that offered counseling to patients with mental, behavioral, and emotional disorders. According to the State of Connecticut’s 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. Medicaid paid Gemini and Apellaniz $909,268 for the false claims. Apellaniz pleaded nolo contendere 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 November 19, 2024.
It is further alleged that in June 2021, Minds Cornerstone LLC, dba Minds Cornerstone Behavior Therapy Services (“Minds Cornerstone”), 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. Beginning in approximately November 2021, Apellaniz, Aponte, and Minds Cornerstone defrauded the Connecticut Medicaid Program by submitting fraudulent claims for applied behavior analysis (“ABA”) services to children diagnosed with Autism Spectrum Disorder (“ASD”). 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.
The complaint specifically alleges 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 (“BCBA”) 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 alleged 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.
From approximately May 2022 until November 2024, Aponte was also employed by the State of Connecticut in the Office of Policy and Management.
Apellaniz and Aponte are charged with conspiracy to commit health care fraud, and health care fraud. Each offense carries a maximum term of imprisonment of 10 years.
U.S. Attorney Avery stressed that a complaint is only a charge and is not evidence of guilt. Charges are only allegations, and each defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.
This investigation is being conducted by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG), and the Medicaid Fraud Control Unit of the Connecticut Chief State’s Attorney’s Office, with the assistance of the Connecticut Department of Social Services. The case is being prosecuted by Assistant U.S. Attorney David T. Huang.