Man Pleads Guilty in $178M MediCal Fraud Scheme

Paul Richard Randall, a 66-year-old resident of Orange County, California, pleaded guilty to one count of wire fraud in federal court for orchestrating a scheme that defrauded California's MediCal program of more than 178 million dollars over 11 months. The fraud, which targeted the state's Medicaid program for low-income residents, involved submitting nearly 270 million dollars in false claims for expensive prescription drugs that were medically unnecessary and often never dispensed to patients.

From May 2022 to April 2023, Randall and his co-conspirators operated through Monte Vista Pharmacy in Orange County, billing MediCal for 19 high-reimbursement, non-contracted medications compounded from low-cost generic ingredients. These included over-the-counter folic acid tablets, marketed as Folite for pain treatment, and pain creams, with some prescriptions billed at thousands of dollars each despite typical costs of just a few dollars for standard supplies. Prosecutors stated that the drugs were procured through illegal kickbacks paid to patient recruiters for beneficiary information and to nurse practitioner Patricia Anderson, who signed pre-filled prescriptions without meeting...