Key Takeaways:
Paul Richard Randall, 66, of Orange, pleaded guilty on April 6 to one count of wire fraud for submitting approximately $269,120,829 in fraudulent Medi-Cal claims, on which the program paid out approximately $178,746,556 over 11 months.
Randall and co-conspirators operated through Monte Vista Pharmacy and exploited Medi-Cal's temporary suspension of prior authorization requirements, billing for expensive non-contracted generic medications that were medically unnecessary and in many cases never dispensed.
Randall was a repeat fraudster, having been convicted in 2012 for a hospital kickback scheme paying doctors and chiropractors up to $20,000 per spinal surgery referral. He has been in federal custody since June 2025 and faces up to 30 years at his August 3 sentencing.
Randall pleaded guilty in downtown Los Angeles to a single count of wire fraud committed while on release, according to a Department of Justice announcement. His plea hearing had been postponed three times previously due to his unavailability.
From May 2022 to April 2023, Randall ran Monte Vista Pharmacy along with co-conspirators Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 58, of West Hills. 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.
"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."
The mechanism was specific. Medi-Cal had suspended its prior authorization requirement during an ongoing transition to a new prescription drug payment system. Randall and Anderson exploited that window to bill for 19 high-reimbursement, non-contracted generic drugs, including Folite tablets, a vitamin available over the counter. The medications were medically unnecessary, often were not dispensed to patients, and were procured through kickbacks, according to the Justice Department.
Assistant Attorney General A. Tysen Duva of DOJ's Criminal Division called Randall "a repeat fraudster." In 2012, he was convicted for running a medical group that paid doctors and chiropractors up to $20,000 per surgery referral.
The guilty plea lands the same week as the FBI's broader Southern California hospice fraud crackdown and California Attorney General Rob Bonta's announcement of Operation Skip Trace, targeting another hospice fraud ring allegedly defrauding Medi-Cal of more than $267 million. Federal administrators have estimated that roughly $3.5 billion in fraud occurred in the hospice and home health care industry in Los Angeles County alone.
Worth sitting with. Two California healthcare fraud cases, same week, same dollar range, same exploited gap between billing systems and verification.
People Also Ask
Q: What is Medi-Cal? A: Medi-Cal is California's version of the Medicaid program, providing health coverage for low-income residents, pregnant women, families, seniors, and people with disabilities. It is jointly funded by the state and federal government.
Q: How did Paul Randall's Medi-Cal fraud scheme work? A: Randall operated through Monte Vista Pharmacy during a period when Medi-Cal had suspended prior authorization requirements for certain medications. He billed for expensive non-contracted generic drugs that were medically unnecessary and often never dispensed, earning over $178 million in payments on $269 million in fraudulent claims.
Q: What is wire fraud? A: Wire fraud is a federal crime under 18 U.S.C. § 1343 that covers schemes to defraud using interstate electronic communications. It carries a statutory maximum of 20 years in prison, or 30 years when certain aggravating factors apply, as in Randall's case of committing fraud while on release.
Q: How common is Medi-Cal fraud in California? A: California led the nation in criminal recoveries for healthcare fraud in fiscal year 2024, yet a 2025 state audit found $1.9 billion in questionable Medi-Cal payments due to eligibility issues. Federal administrators estimate roughly $3.5 billion in hospice and home health care fraud occurred in Los Angeles County alone.
Sources and Related Reading:
U.S. Attorney's Office, Central District of California announcement (via Edhat)
CSLEA: Orange County Man Pleads Guilty to Orchestrating Medi-Cal Fraud Scheme
WYDE: FBI Arrests 15 in $50 Million Southern California Hospice Fraud Crackdown
WYDE: Treasury Proposes Paying Whistleblowers Up to 30% for Reporting Fraud
WYDE: Family Sues Nonprofit Over $21 Million Donor-Advised Fund