U.S. v. Isaura Bou-Melendez and Gricel Font

Case 1:12-cr-20113-MGC Document 1 Entered on FLSD Docket 02/21/2012 Page 1 of 10 

TB 

UNITED STATES DISTRICT COURT 

SOUTHERN DISTRICT OF FLORIDA 

Case No. 

UNITED STATES OF AMERICA 

VS. 

GRICEL FONT 

and 

ISAURA BOU-MELENDEZ, 

Defendants. 

18 U.S.C. 1 371 

18 U.S.C. 5 982 

/ 

INFORM ATION 

The United States Attorney charges that: 

GENERAL ALLEGATIONS 

At a1 times relevant to this Information: 

The M edicare Proaram 

1. The Medicare Program ('dMedicare') was a federaly funded program that provided 

free or below-cost health care benefts to certain individuals, primarily the elderly, blind, and 

disabled. The benefits available under Medicare were governed by federal statutes and 

regulations. The United States Department of Health and Human Services ($'HHS'), through its 

agency, the Centers for Medicare and Medicaid Services ($CMS'), oversaw and administered 

Medicare. lndividuals who received benefits under Medicare were commonly referred to as 

Medicare 'beneficiaries.' 

Code, Section 24(b). 

12-20113-CR-COOKE/TURNOFF 

Feb 21, 2012 

Medicare was a $'hea1th cm'e benefk progrnm,' as defined by Title 18, United States


3. Part A of the Medicare Program was a medical insurance program that covered, 

among other things, certain physician and outpatient services that were medically necessary and 

ordered by licensed medical doctors or other qualified health care providers. Part A of the 

Medicare Program also covered certain outpatient services, including physical therapy, 

rehabilitation and occupational therapy ('PT/OT') services, which were typically administered 

at Comprehensive Outpatient Rehabilitation Facilities (1dCORFs') or by Outpatient Physical 

Therapy Providers ('OPTs'). Medicare Part A covered such services so long as they were 

ordered by a medical doctor or other qualified health care provider, and deemed medicaly 

necessary. 

M edicare Billinz and Pavment Procedures 

4. A CORF or OPT that sought to participate in Medicare Part A and bil Medicare 

for the cost of PT/OT services was required to apply for and receive a I'supplier number' for 

Part A of the Medicare Program. 

For Florida Medicare beneficiaries, Medicare Part A PT/OT benefhs were 

administered by First Coast Service Options ('dFirst Coast'), pursuant to a contract with HHS to 

receive, process and pay claims. First Coast received,adjudicated and paid the claims of 

authofized PT/OT providers that were seeking reimbursement for the cost of PT/OT services 

supplied or provided to Medicare benefciaries. 

To receive payment from Medicare, a CORF or OPT, using its Part A supplier 

number, would submit a health insurance claim form known as a CMS-1450. Medicare 

permited CORF and OPT companies to submit CMS-1450's electronicaly or by way of a paper 

claim form. Each claim form required certain information, including: (a) the Medicare 

beneiciary's nnme and identification number; (b) the identification number of the doctor or other 

2


qualitied health care provider who ordered or furnished the health care benefk , item, or service 

that was the subject of the claim; (c) the health care benetk, item, or service that was provided or 

supplied to the beneticiary; (d) the biling codes for the beneft, item, or service; and (e) the date 

upon which the benefit, item, or service was provided or supplied to the beneficiary . 

Medicare, through First Coast, would generaly pay a substantial portion of the 

cost of the related health care beneûts, items, and services that were medicaly necessary and 

ordered by licensed doqtors or other qualified health care providers. 

Payments under Medicare Part A were often made directly to the CORF or OPT 

company rather than to the patient/beneficiary. For this to occur, the beneficiary would assign 

the right of payment to the COR.F or OPT company or other health care providers . Once such an 

assignment took place, the CORF or OPT company would assume the responsibility for 

submiting claims to, and receiving payments from, Medicare. 

Font & Bou Associates Rehab. Inc. 

Font & Bou Associates Rehab, lnc.(hereinafter EtFont & Bou') was a Florida 

corporation incorporated on Decembtr 7, 2004, that was located in Miami-Dade County , 

purportedly providing PT/OT services to Medicare beneficiaries. 

10. Font & Bou's principal place of business was located at 14100 Palmetto Frontage 

Road, #380, Miami Lakes, Florida. 

The Defendants 

1 1. Defendant GRICEL FONT was a resident of Broward County, in the Southern 

District of Florida. FONT was president and registered agent of Font & Bou 

Defendant ISAURA BOU-M ELENDEZ was a resident of Broward County , in 

the Southern District of Florida. BOU-MELENDEZ was vice-president of Font & Bou .


CONSPIRACY TO COMM IT HEALT - H CARE FM UD 

(18 U.S.C. 5 371) 

13. Btginning on or about January 2, 2006, and continuing tlrough on or about 

February 25, 2010, in Miami-Dade County, in the Southern District of Florida , and elsewhere, 

the defendants, 

GW CEL FONT 

and 

ISAURA BOU MELENDEZ, 

did wilfully, that is, with the intent tofurther the object of the conspiracy, and knowingly 

combine, conspire, confederate and agree with each other and others known and unknown to the 

United States Attorney, to violate Title 18, United States Code, Section 1347 , that is, to execute a 

scheme and artifice to defraud Medicare, a health care benetit program afecting commerce , as 

defined in Title 18, United States Code, Section 24(b), and to obtain, by means of materialy 

false and fraudulent pretenses, representations, and promises, money and property owned by , and 

under the custody and control of Medicare, in connection with the delivery of and payment for 

health care benefits, items, and services. 

PURPOSE OF THE CONSPIRACY 

14. It was the purpose of the conspiracy for the defendants and their co-conspirators 

to unlawfully enrich themselves by, among other things: (a) submiting or causing the 

submission of false and fraudulent claims to Medicare; (b) concealing the submission of false 

and fraudulent claims to Medicare and the receipt and transfer of fraud proceeds; and (c) 

diverting fraud proceeds for the personal use and benefh of themselves and others . 

4


M ANNER AND MEANS OF THE CONSPIM CY 

The manner and means by which the defendants and their co-conspirators sought to 

accomplish the object and purpose of the conspiracy included, among other things, the 

folowing: 

& Bou. 

15. GRICEL FONT and ISAURA BOU-MELENDEZ owned and controled Font 

Beginning on or about January 2, 2006, and continuing tlzrough on or about 

February 25, 2010, GRICEL FONT, ISAURA BOU-M ELENDEZ, and their co-conspirators 

submitted and caused Font & Bou to submit approximately $6,908,986 in Medicare claims for 

P'T/oT-related reimbursement, which claims falstly and fraudulently represented that PT/OT 

items and services were prescribed by a doctor and provided to Medicare benetkiaries . 

As a result of such false and fraudulent claims, Medicare deposited approximately 

$4,944,057 into Font & Bou's corporate accounts. 

18. GRICEL FONT, ISAURA BOU-MELENDEZ and their co-conspirators used 

the proceeds of the health care fraud for their personal benefit and to further the fraud. 

OVERT ACTS 

ln furtherance of the conspiracy, and to accomplish its purpose and object, at least one of 

the co-conspirators commited, or cause to be committed, in the Southern District of Florida , and 

elsewhere, at least one of the folowing overt acts, among others: 

On or about September 25, 2009, GRICEL FONT and ISAURA BOU- 

MELENDEZ, through Font & Bou, submited a claim on behalf of Medicare beneficiary I .C. for 

PT/OT services, when in fact no PT/OT services were provided to I.C. by Font & Bou.


On or about October 9, 2009, GRICEL FONT and ISAUM BOU- 

MELENDEZ. through Font & Bou, submited a claim on behalf of Medicre beneticiary B .V. 

for PT/OT services, when in fact no PT/OT services were provided to B .V. by Font & Bou. 

On or about October 16, 2009, GRICEL FONT and ISAURA BOU- 

MELENDEZ, through Font & Bou, submitted a claim on behalf of Medicare benesciary T .R. 

for PT/OT services, when in fact no PT/OT services were provided to T.R. by Font & Bou. 

All in violation of Title 18, United States Code, Section 371 . 

FORFEITURE 

(18 U.S.C. j982) 

The allegations contained in this Information are realeged and incorporated by 

reference as though fuly set forth herein for the purpose of alleging forfeiture to the United 

States of America of certain property in which the defendants, GRICEL FONT and ISAURA 

BOU-MELENDEZ, have an interest. 

2. Upon conviction of the violation as aleged in this Information, the defendants 

shall forfeit al1 of their right, title and interest to the United States of any property, real or 

personal, that constitutes or is derived, directly or indirectly, from gross proceeds traceable to the 

commission of such violation, pursuant to Title 18, United States Code, Section 982(a)(7). 

3. The property subject to forfeiture includes, but is not limited to, the sum of 

$4,944,057 in United States currency, which sum is equal to the gross proceeds traceable to the 

commission of the violation alleged in this lnformation, which the United States wil seek as a 

forfeiture moneyjudgment as part of the defendant's sentence. 

6


A1l pursuant to Title 18, United States Code, Section 982(a)(7); and the procedures set 

forth at Title 21, United States Code, Section 853, as made applicable through Title 18, United 

States Code, Section 982(b)(1). 

h 

WlF O A. FERRER 

UNITED STATES ATTORNEY 

JO .JUE GER 

AS STAN UNITED STATES ATTORNEY

UNITED STATES DISTRICT GOURT 

Case 1:12-cr-20113-MGC Document SOUTHERN 1 Entered DISTRICT on OF FLSD FLORIDA Docket 02/21/2012 Page 8 of 10 

UNITED STATES OF AMERICA 

V9. 

GRICEL FONT and 

ISAURA BOU-MELENDEZ 

Coud Division: (select one) 

Defendants. I 

X FTu Miami wKe 

)B West FTp 

I do hereby cedify that: 

5. 

CASE NO. 

CERTIFICATE OF TRIAL ATTORNEY* 

Superseding Case Information: 

New Defendants) Yes . No 

Number of New Defendants 

Total number of counts 

I have carefully considered the allegations gf the indictm:nt the number qf defendants the number of 

probable witnesses and the legal complexlties of the IndlctMenvlnformatlon atached hereto. 

I am Mware that the information supplied ?n thij qtaterpent wil be relied upon b ythe 

Ju d pes 

of this 

Court ln Seting theirçalendars and schedulng crlmlnal trlals underthe mandate of the Speedy Trial Act 

Title 28 U.S.C. Sectlon 3161. 

, 

Iqterpreter: LIst Ianguage and/or (Yes dlalec gr Nj 

This case wil take n 

Please check appropriate category and type of offense listed below: 

(Check only one) 

0 to 5 days 

6 to 10 days 

1 1 to 20 days 

21 to 60 days 

61 days and over 

Nn 

days for the parties to try. 

6. If Has this case been previously filed in this District Coud? (Yes or No) Mn 

Judge: yes: 

Case No. 

(Attach H copy 9f dispositive Vrdel) 

If as a complalnt been filed In thls mater? (Yes Or No) Nn 

Maglstrate yep: 

Case No. 

Related Misc:laneous numbers: 

Defendants) ln federal custody as of 

Defendantls) R In state custody as of 

ule 20 from the District of 

ls this a potential death penalty case? (Yes or No) 

8. 

(Check only one) 

P'tty 

Mlnor 

Mlsdem. 

Felony 

Doesthiscaseor gi inate from a matterpending in the Nodhern Region of the U.S. Attorney's Office prior 

0' 03? Yes Y No 

to October 14, 2 

Does this case originate from a matter pending in the Central Region of the U.S. Attorney's Office prior 

to September 1, 2D07? 

Yes Y No 

.. - ' 

JON J GER 

AS>I Fl ANT U ED STATES ATTORNEY 

orlda Bar No. 56108 

*penalty Sheets) atached REV 4/KQ8


Defendant's Name: GRICEL FONT 

Count #: 1 

Conspiracy to Commit Hea1th Care Fraud 

Title 18. United States Code. Section 371 

* Max. Penalty: 5 years' imprisonment 



PENALTY SHEET 

WRefers only to possible term of incarceration, does not include possible fines, restitution, 

special assessments, parole terms, or forfeitures that may be applicable.




PENALTY SHEET 

Defendant's Name: ISAURA BOU-M ELENDEZ 

Case No: - . 

Count #: 1 

Conspiracy to Commit Health Care Fraud 

Title 18. United States Code. Section 371 

* Max. Penalty: 5 years' imprisonment 

WRefers only to possible term of incarceration, does not include possible fines, restitution , 

special assessments, parole terms, or forfeitures that may be applicable.

U.S. v. Isaura Bou-Melendez and Gricel Font

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?