Medi-Cal Fraud Case Uncovers Massive Taxpayer Losses

Clear Facts

• A 66-year-old California man pleaded guilty to submitting nearly $270 million in fraudulent claims to Medi-Cal.
• The scheme exploited a temporary suspension of prior authorization rules to bill for unnecessary or undispensed medications.
• Law enforcement officials have seized approximately $126.5 million in assets tied to the alleged theft.

Paul Randall of Orange County admitted to defrauding California’s Medicaid program, known as Medi-Cal, over an 11-month period. Working with a pharmacist and a nurse practitioner, Randall billed for expensive prescription drugs that were either medically unnecessary or never actually dispensed.

The group targeted high-reimbursement medications containing cheap ingredients. They sometimes billed thousands of dollars for simple vitamins.

This criminal activity occurred while Randall was already on release for a separate criminal case.

“Thanks to the leadership of President Donald Trump, the Department, working closely with the Task Force to Eliminate Fraud, is supercharging efforts to take down every fraudster and bring them to justice,” said Acting Attorney General Todd Blanche.

“In one day, the Department prosecuted the theft of a half-billion in taxpayer dollars. All those ripping off the American people are on notice.”

The fraud involved paying illegal kickbacks to patient marketers and a nurse practitioner who signed pre-filled prescriptions. These prescriptions were for generic drugs manufactured in unique dosages to avoid price caps that typically limit reimbursements.

“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.

“He and his co-schemers stole over $178 million through false and fraudulent claims for these medications, lining their own pockets with public funds.”

Randall pleaded guilty to one count of wire fraud and faces a maximum penalty of 30 years in prison during his August sentencing. His co-conspirators, Kyrollos Mekail and Patricia Anderson, have also pleaded guilty to health care fraud charges.

“This plea shows our firm resolve, alongside our law enforcement partners, to expose such fraud operations, ensuring those responsible are held accountable, and safeguarding taxpayer-funded health care programs,” said Acting Deputy Inspector General Scott J. Lampert.

The government’s asset seizure included over $111 million in bank funds, luxury real estate, high-end vehicles, and significant sports memorabilia collections. This prosecution is part of a broader federal push to eliminate fraud and protect American taxpayers from systemic exploitation.

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