Massachusetts prosecutors have announced the indictment of four individuals related to “a wide-spread personal care attendant and home health Medicaid fraud scheme.”
According to the state’s Office of the Attorney General, the defendants allegedly billed over $500,000 to MassHealth for home health services that were not provided, including services by personal care attendants, home health aides or adult foster care caretakers.
The indictments allege that on multiple occasions since at least 2019, MassHealth was fraudulently billed for home health services that were not provided. The AG’s Office alleges that Felix Mercedes, of Worcester, targeted vulnerable community members, including homeless and disabled individuals, for the scheme, often inviting them to stay in his home.
Mercedes then allegedly used the personal information of the victims to sign them up for MassHealth services, including personal care and other home health services, often without their knowledge or consent. The home health services were then billed to MassHealth, despite never being provided.
The AG’s office alleges that this scheme involved false billing for at least 17 different MassHealth members, causing many of those members not to receive critical, medically necessary health services that they needed. Mercedes and his co-conspirators allegedly utilized the MassHealth funds for personal expenses, including travel, lifestyle, jewelry and various luxury items, along with a downpayment on a home in Worcester.
All of the above-referenced charges are allegations, and the defendants are presumed innocent until proven guilty, the AG Office stresses in the release.