Source: United States Department of Justice Criminal Division
A California man was sentenced today to 30 years in federal prison for masterminding a massive health care fraud scheme in which nearly $270 million in fraudulent claims were submitted over an 11-month span to Medi-Cal, the California Medicaid program, for expensive prescription drugs containing generic ingredients that were medically unnecessary and, many times, were not provided to the purported recipients. The sentence marks one of the highest health care fraud sentences in the Central District of California’s history.
Paul Richard Randall, 67, of Orange, California, was also ordered to pay $178,746,556.22 in restitution.
“Paul Randall exploited a temporary change in Medi-Cal’s prescription drug reimbursement system to steal millions of hard-earned taxpayer dollars meant to help California’s most vulnerable residents,” said Assistant Attorney General Colin M. McDonald of the National Fraud Enforcement Division. “Today’s sentence sends a clear message to those who would abuse our public benefit programs to line their own pockets: The Fraud Division will aggressively prosecute you and seek to hold you accountable to the fullest extent under the law.”
“This case exposes unbridled greed at the expense of patients and taxpayers. Stealing funds meant for essential care and corrupting medical decisions through kickbacks is deeply harmful and erodes trust in our health care system,” said Acting Deputy Inspector General for Investigations Miranda L. Bennett of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG, together with our law enforcement partners, will continue to pursue those who exploit federal health care programs and ensure they are held fully accountable.”
“This defendant took advantage of California’s weak systems allowing him to submit $270 million in fraudulent claims to Medi-Cal in less than a year,” said First Assistant U.S. Attorney Bill Essayli of the Central District of California. “Today’s prison sentence underscore’s our department’s determination to aggressively punish criminals who steal from public health programs.”
According to court documents, Randall, along with pharmacist and pharmacy owner Kyrollos Mekail, 38, of Moreno Valley, California, and nurse practitioner Patricia Anderson, 59, of West Hills, California, took advantage of Medi-Cal’s suspension of its requirement that health care providers obtain prior authorization before providing certain h medications as a condition of reimbursement. The suspension of the prior authorization requirement 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 (Monte Vista), Randall and his co-conspirators exploited Medi-Cal’s prior authorization suspension by billing Medi-Cal tens of millions of dollars per month for dispensing high-reimbursing, non-contracted generic drugs through Monte Vista. The medications, which included pain creams and Folite tablets, a vitamin available over the counter, were billed for thousands of dollars each, including approximately $13,424 for one prescription of meloxicam 5 mg, a generic drug that typically costs between $5 and $25 for a 30-day supply in larger dosages. Normally, these high-cost reimbursement medications would have required prior authorization under Medi-Cal’s previous payment system. Medication involved in this scheme was medically unnecessary, frequently not dispensed to patients, and procured by illegal kickbacks.
In furtherance of the scheme, Randall paid illegal kickbacks to patient marketers in exchange for Medi-Cal beneficiary information and to Anderson to sign pre-filled prescriptions for the medications. Anderson never met the patients, reviewed their medical records, or otherwise determined that the medications were medically necessary before signing the prescriptions.
From May 2022 to April 2023, Randall caused at least $269,120,829 in false and fraudulent claims to be submitted to Medi-Cal, of which Medi-Cal paid at approximately $178,746,556. Randall committed this offense while on release in another criminal tax case in the Central District of California (United States v. Paul Richard Randall, No. CR 20-00031-GW).
Randall and his co-conspirators laundered their illicit proceeds by transferring them to a third party to pay hundreds of thousands of dollars in illegal kickbacks to Anderson in exchange for Anderson signing the fraudulent prescriptions.
In April 2026, Randall pleaded guilty to one count of wire fraud. In his plea agreement, Randall agreed to forfeit property obtained from the fraud, including bank account balances exceeding $17 million, three vehicles, seven real properties, and sports memorabilia. To date, the government has seized approximately $126.5 million in assets that Randall and his co-conspirators accumulated from the scheme, including $111 million in bank funds and securities, nine luxury vehicles totaling approximately $1 million, nine luxury real properties totaling approximately $13.5 million, and more than $1 million worth of sports memorabilia.
FBI, HHS-OIG, and the California Department of Justice investigated the case.
Trial Attorney Siobhan M. Namazi of the Fraud Division’s Health Care Fraud Section and Assistant U.S. Attorney Roger A. Hsieh for the Central District of California prosecuted the case. Assistant U.S. Attorney James E. Dochterman for the Central District of California’s Asset Forfeiture and Recovery Section is handling asset forfeiture matters in this case.
On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division. The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.
The Department of Justice’s Health Care Fraud Strike Force Program, currently comprised of nine strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion since 2007. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.
More information can be found at www.justice.gov/fraud.