Nearly $270 million in bogus claims submitted to Medi-Cal, the California Department of Justice is assisting in investigating this matter

“Thank you to the investigating agencies that work to protect public health funds from unscrupulous and greedy individuals who think they can cash in via fraudulent means.  $270 million in fraudulent claims over an 11-month period is jaw dropping.”

CSLEA President Alan Barcelona

LOS ANGELES – On April 6, 2026, Paul Richard Randall, 66, of Orange, pleaded guilty to submitting nearly $270 million in fraudulent claims over an 11-month span to Medi-Cal for expensive prescription drugs containing generic ingredients that were not medically necessary and, in many instances, not provided to the purported recipients.  Randall pleaded guilty to one count of wire fraud committed while on release. He has been in federal custody since June 2025.

“This defendant used a public health program as his personal piggy bank,” said First Assistant U.S. Attorney Bill Essayli.

“The defendant was a repeat fraudster who caused Medi-Cal, a program designed to help those in need, to be billed nearly $270 million for expensive and medically unnecessary medications,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division. “He and his co-schemers stole over $178 million through false and fraudulent claims for these medications, lining their own pockets with public funds. The Criminal Division will aggressively prosecute those who defraud Medicaid and exploit taxpayer-funded benefit programs.”

According to his plea agreement, Randall, along with Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 58, of West Hills, took advantage of Medi-Cal’s suspension of its requirement that health care providers obtain prior authorization before providing certain health care services or medications as a condition of reimbursement. The suspension of the prior authorization requirements was part of an ongoing transition of Medi-Cal’s prescription drug program to a new payment system.

Through a business called Monte Vista Pharmacy, Randall and his co-schemers exploited Medi-Cal’s prior authorization suspension by billing Medi-Cal tens of millions of dollars per month for dispensing high-reimbursement, non-contracted, generic drugs through Monte Vista Pharmacy. Some prescription medications purportedly were to treat pain and included Folite tablets, a vitamin available over the counter.

Normally, these high-cost reimbursement medications would have required prior authorization under Medi-Cal’s old payment system. Medication involved in this scheme was medically unnecessary, frequently was not dispensed to patients, and procured by kickbacks.

From May 2022 to April 2023, Monte Vista billed Medi-Cal more than $269 million and was paid more than $178 million for 19 expensive, non-contracted drugs containing low-cost, generic ingredients that were not medically necessary, not provided, or both.

Randall and others then laundered their illicit proceeds by transferring the proceeds of the Medi-Cal fraud scheme to a third party to pay kickbacks to Anderson, to promote the fraud scheme and to conceal and disguise the transfers from detection by law enforcement.

Randall admitted in his plea agreement to transmitting by wire at least approximately $269,120,829 in false and fraudulent claims to Medi-Cal for purportedly dispensing the fraud scheme medications that Anderson prescribed, on which Medi-Cal paid at least approximately $178,746,556.

United States District Judge Mark C. Scarsi scheduled an August 3 sentencing hearing, at which time Randall will face a statutory maximum sentence of 30 years in federal prison.

Relatedly, Mekail pleaded guilty in August 2024 to two counts of health care fraud and awaits sentencing. Anderson is charged with two counts of health care fraud.

The United States Department of Health and Human Services Office of Inspector General (HHS-OIG), the FBI, and the California Department of Justice are investigating this matter.

Assistant United States Attorney Roger A. Hsieh of the Major Frauds Section and Trial Attorney Siobhan M. Namazi of the U.S. Department of Justice, Criminal Division, Fraud Section are prosecuting this case. Assistant United States Attorney James E. Dochterman of the Asset Forfeiture and Recovery Section is handling asset forfeiture matters in this case.