Press Release  AG Campbell Secures Guilty Plea From Ringleader Of Worcester-Based Home Health Fraud Scheme Exploiting Vulnerable Residents

BOSTON — Attorney General Andrea Joy Campbell today announced that Felix Mercedes, 35, of Worcester, pleaded guilty to orchestrating a widespread MassHealth fraud scheme involving the stealing of personal information from disabled, elderly, and unhoused individuals to bill for false home health services in the Worcester area. According to the Attorney General’s Office (AGO), Mercedes and co-conspirators billed MassHealth over $500,000 for home health services that were never provided, including services related to MassHealth’s Personal Care Attendant (PCA), Home Health Aide (HHA), and Adult Foster Care (AFC) programs.

On September 11, 2025, as a result of charges brought by the AGO, Mercedes pleaded guilty in Worcester County Superior Court to Medicaid False Claims, Larceny over $1,200, Conspiracy to Commit Larceny and Medicaid Fraud, Identity Fraud, and Money Laundering. As a result of the plea, Mercedes was sentenced to 1-3 years in state prison, 5 years of probation, and ordered to pay $500,000 in restitution to the Commonwealth. Additionally, Mercedes was barred from any responsibilities related to the MassHealth program and from working with the elderly or disabled.

“MassHealth serves our most vulnerable residents including our seniors, ensuring they have access to high-quality home healthcare services,” said AG Campbell. “As in this case and future matters, our Medicaid Fraud Division will continue to protect these taxpayer-funded programs and hold accountable those who intentionally seek to defraud our seniors and the MassHealth program.”

In March 2024, the AGO secured indictments against Mercedes and his co-conspirators in relation to the fraud scheme. The AGO alleged that since at least 2019, Mercedes targeted vulnerable community members in the Worcester area, including homeless, elderly, and disabled individuals, and would often invite victims to stay in his home. Mercedes then fraudulently used their personal information to sign them up for MassHealth services, including PCA and other home health services, often without their knowledge or consent. Mercedes and his co-conspirators would bill the services to MassHealth, despite the services never being provided.

Throughout his scheme, Mercedes falsely billed for at least seventeen different MassHealth members, causing many of those members not to receive critical, medically necessary health services. Mercedes and his co-conspirators allegedly utilized the MassHealth funds for personal expenses, including travel, lifestyle, jewelry, and various luxury items, including from brands such as Gucci and Coach, and a downpayment on a home in Worcester.

MassHealth’s Personal Care Attendant (PCA) program helps individuals with chronic or long-term disabilities live independently in their community by providing medically necessary physical assistance with personal care needs. Through the PCA program, eligible MassHealth members employ PCAs to assist them with their activities of daily living. These services are paid for by MassHealth through a fiscal intermediary. Community-based HHA and AFC programs also provide home health services to MassHealth members.

This matter is representative of the AGO’s commitment to combatting MassHealth fraud, including fraud of MassHealth’s PCA program. Last week, following charges brought by the AGO, a Randolph personal care attended pleaded guilty to defrauding the PCA program and was sentenced to 18 months in jail. In June 2025, as a result of charges brought by the AGO, a personal care attendant pleaded guilty to defrauding the PCA program and was sentenced to one year in state prison and ordered to pay restitution. Additionally, in June 2025, following indictments by the AGO, a former South Deerfield resident pleaded guilty to defrauding the PCA program and was sentenced to two years in the House of Correction, suspended for two years.  

This matter was handled by the AGO’s Medicaid Fraud Division. Substantial assistance was provided by the Office of the Inspector General for the U.S. Department of Health and Human Services, the Office of the State Auditor’s Bureau of Special Investigations, the Social Security Administration’s Office of Inspector General, the Massachusetts State Police assigned to the Office of the Attorney General, the Worcester Police Department’s Special Crimes Unit, and MassHealth.

The AGO’s Medicaid Fraud Division is a Medicaid Fraud Control Unit, annually certified by the U.S. Department of Health and Human Services to investigate and prosecute health care providers who defraud the state’s Medicaid program, MassHealth. The Medicaid Fraud Division also has jurisdiction to investigate and prosecute complaints of abuse, neglect and financial exploitation of residents in long-term care facilities and of Medicaid patients in any health care setting. Individuals may file a MassHealth fraud complaint or report cases of abuse or neglect of Medicaid patients or long-term care residents by visiting the AGO’s website.  

The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,922,320 for federal fiscal year 2025. The remaining 25 percent, totaling $1,974,102 for FY 2025, is funded by the Commonwealth of Massachusetts.  

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