Connecticut Man Sentenced for $900K Medicaid Fraud Involving Unlicensed Counseling Claims

In Hartford, Connecticut, Ramon Apellaniz has been sentenced to 15 months in prison for his involvement in a Medicaid fraud scheme, totaling fraudulent claims of over $900,000. This sentence was handed down in Hartford Superior Court by Judge David P. Gold, who also ordered Apellaniz to serve five years of probation post-release, with potential additional prison time for any probation violations.

The fraud was conducted through Gemini Project, LLC., a Newington-based company claiming to offer counseling services. Investigations by the Medicaid Fraud Control Unit revealed that Apellaniz, who is unlicensed, submitted thousands of claims for services either conducted by unlicensed individuals or not provided at all. Apellaniz, the sole principal of Gemini Project, falsely used the provider number of a licensed professional to submit 12,771 claims, with 9,717 of these being illegitimate.

Having already paid $156,000, Apellaniz now owes an additional $753,269 in restitution. This case highlights significant vulnerabilities in healthcare billing systems and underscores the importance of vigilant oversight to prevent such fraudulent activities.