East Hartford Man Charged with Filing Hundreds of Bogus Medicaid Claims
An East Hartford man was arrested today and charged with submitting hundreds of bogus claims to Medicaid and also billing the government health insurance program in thousands of other instances where services were rendered by unlicensed personnel.
RAMON APELLANIZ, age 34, of Hilltop Farms Lane in East Hartford, was arrested by Inspectors from the Medicaid Fraud Control Unit (MFCU) in the Office of the Chief State’s Attorney on a warrant charging him with one count each of Larceny in the First Degree by Defrauding a Public Community, Health Insurance Fraud and Identity Theft in the First Degree.
According to the arrest warrant affidavit, Apellaniz is not licensed to provide counseling services but is listed as the sole principal of the Gemini Project, LLC, a Newington business that offered counseling to numerous patients with mental, behavioral and emotional disorders, but employed only one professional who was actually licensed to do so.
MFCU Inspectors determined that 9,617 of the 12,571 claims submitted by the Gemini Project for the 18-month period between January 2018 and July 2019 were for services provided by unlicensed persons. The value of these claims totaled $909,269.
Subsequent investigation uncovered an additional 462 claims submitted for services that were either not rendered at all or were not rendered as claimed. The value of these claims totaled $39,346, the warrant states.
Apellaniz was released on a $1 million non-surety bond and is scheduled to appear in Hartford Superior Court on January 29, 2020. The charges are merely accusations and he is presumed innocent until and unless proven guilty.
Larceny in the First Degree by Defrauding A Public Community and Identity Theft in the First Degree are class B felonies each punishable by up to 20 years in prison. Health Insurance Fraud is an unclassified felony punishable by up to 5 years in prison.
The case will prosecuted by the Medicaid Fraud Control Unit. The Unit is grateful for the assistance it received in this investigation from the state Department of Social Services Office of Quality Assurance, the state Attorney General’s Office and the New Britain Police Department.