East Hartford Man Imprisoned For Bilking Medicaid: State

EAST HARTFORD/NEWINGTON, CT — An East Hartford man who owned a Newington counseling services operation was sent to prison Wednesday for bilking the Medicaid program of more than $909,000.

Authorities said Ramon Apellaniz, 39, was sentenced in Hartford Superior Court for submitting thousands of fraudulent claims to Medicaid.

Those claims, state officials said, were for services provided by unlicensed personnel, services not provided, and stealing the identity of a licensed professional to submit the fraudulent claims.

Apellaniz was sentenced to eight years in prison, execution suspended after 15 months served, with five years of probation.

Officials said he has paid $156,000 in restitution, with the remaining $753,269 to be paid during probation.

Apellaniz pleaded nolo contendere on Sept. 12, 2023, to one count of first-degree larceny, one count of health insurance fraud, and one count of first-degree identity theft. All are classified as B felonies.

According to the state, an investigation by the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney determined Apellaniz was not licensed to provide counseling services.

Authorities said he was, however, listed as the sole principal of the Gemini Project, LLC., a Newington business that offered to counsel numerous patients with mental, behavioral, and emotional disorders.

State officials said he employed one professional who was a licensed counselor.

The Medicaid Fraud Control Unit determined 9,717 of 12,771 claims submitted by the Gemini Project between January 2018 and July 2019 were for services provided by unlicensed persons, including Apellaniz himself, according to authorities.

In addition, officials said, a total of 462 claims were submitted for services that were never rendered.

Officials said Apellaniz used the provider number of a licensed provider, without their knowledge or permission, to submit the fraudulent claims and obtain $909,269 in fraudulent billings.

For more information about the case, click on this link.