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Worcester County Courthouse (mass.gov)
A Worcester man who led a scheme to defraud MassHealth out of more than $500,000 by exploiting the personal information of vulnerable residents has pleaded guilty and been sentenced to state prison, Attorney General Andrea Joy Campbell announced Monday.
Felix Mercedes, 35, admitted in Worcester County Superior Court that he and co-conspirators stole the identities of elderly, disabled, and unhoused individuals to bill MassHealth for services that were never provided. Prosecutors said the scheme targeted at least 17 MassHealth members in the Worcester area.
On September 11th, Mercedes pleaded guilty to Medicaid False Claims, Larceny over $1,200, Conspiracy to Commit Larceny and Medicaid Fraud, Identity Fraud, and Money Laundering. He was sentenced to 1 to 3 years in state prison, followed by 5 years of probation, and ordered to pay $500,000 in restitution. He is barred from any responsibilities related to MassHealth and from working with the elderly or disabled.
According to the Attorney General’s Office, Mercedes and his associates used the fraud proceeds for personal expenses including travel, lifestyle purchases, jewelry, luxury brands such as Gucci and Coach, and a down payment on a home in Worcester.
Officials said many targeted victims went without critical, medically necessary services.
The case stems from indictments secured by the Attorney General’s Office in March 2024. Authorities alleged the scheme began by at least 2019, when Mercedes would sometimes invite victims to stay in his home, then use their information—often without their knowledge or consent—to enroll them in Personal Care Attendant, Home Health Aide, and Adult Foster Care programs. Services were billed but not provided.
Officials said the prosecution is part of a broader effort targeting fraud in MassHealth’s PCA and other community-based programs.
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