Orange County Man Pleads Guilty in $270 Million Medi-Cal Fraud Scheme

Orange County Man Pleads Guilty in Massive $270 Million Medi-Cal Fraud Scheme

An Orange County resident has admitted to orchestrating one of the largest Medi-Cal fraud schemes in recent history, submitting nearly $270 million in fraudulent claims for unnecessary prescription drugs over just 11 months.

Paul Richard Randall, 66, of Orange, California, pleaded guilty Monday to one count of wire fraud committed while on release. Randall, who has been in federal custody since June 2025, exploited a temporary suspension in Medi-Cal’s prior authorization requirements to bill the program for expensive medications that were often never provided to patients.

“This defendant used a public health program as his personal piggy bank,” said First Assistant U.S. Attorney Bill Essayli. “This guilty plea should send a message that this administration — consistent with the President’s war on fraud — will not turn a blind eye while criminals fleece taxpayers.”

According to court documents, Randall collaborated with Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 58, of West Hills, to take advantage of Medi-Cal’s temporary policy change. The suspension of prior authorization requirements was implemented during Medi-Cal’s transition to a new payment system.

Through a business called Monte Vista Pharmacy, the group billed Medi-Cal for high-reimbursement, non-contracted generic drugs that would normally have required approval under the program’s standard protocols. Many of these medications were purportedly for pain management and included Folite tablets, which are vitamins available over the counter.

From May 2022 to April 2023, Monte Vista billed Medi-Cal more than $269 million and received over $178 million in payments for 19 expensive, non-contracted drugs containing low-cost, generic ingredients. Prosecutors assert these medications were medically unnecessary, frequently not dispensed to patients, and often obtained through kickback arrangements.

“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 case highlights ongoing vulnerabilities in public healthcare programs, particularly during administrative transitions. Medi-Cal, California’s Medicaid program, provides healthcare coverage to low-income residents and is funded by both state and federal dollars. Fraud schemes like Randall’s divert critical resources away from legitimate patient care.

According to Acting Deputy Inspector General Scott J. Lampert of the U.S. Department of Health and Human Services, “Schemes that bill Medicaid for costly drugs that patients never needed or received threaten the integrity of the program. This plea shows our firm resolve, alongside our law enforcement partners, to exposing such fraud operations, ensuring those responsible are held accountable, and safeguarding taxpayer-funded health care programs.”

The scheme extended beyond fraudulent billing. Randall and his associates also engaged in money laundering to conceal their activities, transferring proceeds to third parties to pay kickbacks to Anderson, to further promote the fraud scheme, and to hide the transactions from law enforcement.

Randall admitted in his plea agreement to transmitting at least approximately $269,120,829 in false and fraudulent claims to Medi-Cal, which paid out at least $178,746,556 on these claims.

United States District Judge Mark C. Scarsi has scheduled sentencing for August 3, when Randall will face a maximum potential sentence of 30 years in federal prison.

In related proceedings, Mekail pleaded guilty in August 2024 to two counts of health care fraud and is awaiting sentencing. Anderson has been charged with two counts of health care fraud.

The investigation was conducted by the U.S. Department of Health and Human Services Office of Inspector General, the FBI, and the California Department of Justice. The case is being prosecuted by Assistant United States Attorney Roger A. Hsieh of the Major Frauds Section and Trial Attorney Siobhan M. Namazi of the Justice Department’s Criminal Division, Fraud Section. Asset forfeiture matters are being handled by Assistant United States Attorney James E. Dochterman.

Healthcare fraud continues to be a priority for federal prosecutors, with the Department of Justice estimating that healthcare fraud costs American taxpayers billions of dollars annually. This case represents part of the broader effort to combat such schemes and protect the integrity of vital public health programs.