An Orange County man received a 30-year federal prison sentence for leading an elaborate Medi-Cal billing fraud that routed nearly $270 million in false claims through a pharmacy scheme, resulting in more than $178 million in payments and massive forfeitures.
An Orange County man was sentenced to 360 months in federal prison after admitting he organized a sprawling healthcare fraud scheme that funneled almost $270 million in false claims to Medi-Cal over an 11-month span. The court also ordered $178,746,556 in restitution tied to the scheme’s ill-gotten gains.
The fraud involved billing for expensive prescription drugs that were built from low-cost, generic ingredients, many of which were not medically necessary and often were never dispensed. Investigators say the claims were designed to exploit reimbursement rules and generate large, rapid payouts.
Paul Richard Randall, 67, pleaded guilty on April 7 to one count of wire fraud committed while on release, and Judge Mark C. Scarsi imposed the 360-month sentence. Randall’s operation centered on a pharmacy business that aggressively billed Medi-Cal for high-reimbursement, non-contracted medications.
“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 United States Attorney Bill Essayli. “Today’s prison sentence underscore’s our department’s determination to aggressively punish criminals who steal from public health programs.”
Randall did not act alone. He worked with Kyrollos Mekail, 38, of Moreno Valley, and Patricia Anderson, 59, of West Hills, to exploit a temporary suspension of Medi-Cal’s prior authorization requirement during a transition to a new payment system. That suspension created a window the conspirators used to submit tens of millions of dollars in monthly billings without the usual controls.
“Paul Randall exploited a temporary change in Medi-Cal’s prescription drug reimbursement system to steal hundreds of millions of hard-earned taxpayer dollars meant to help California’s neediest 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 permissible under the law.”
Medi-Cal is California’s Medicaid program that provides healthcare to low-income people, persons with disabilities, and children in foster care. “This case exposes unbridled greed at the expense of patients and taxpayers,” said Acting Deputy Inspector General for Investigations Miranda L. Bennett at the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Stealing funds meant for essential care and corrupting medical decisions through kickbacks is deeply harmful and erodes trust in our health care system. 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.”
The scheme operated through a business called Monte Vista Pharmacy, which billed Medi-Cal for 19 non-contracted, high-cost drugs that in reality contained low-cost generic ingredients. Some of the medications billed included items like Folite tablets, an over-the-counter vitamin, listed as if they were expensive, prescription-only treatments.
“The amount of money Paul Randall stole from California taxpayers through his fraud scheme is staggering,” said Patrick Grandy, the Assistant Director in Charge of the FBI’s Los Angeles Field Office. “By exploiting a loophole in the Medi-Cal system, he was able to bill nearly $270 million dollars, then launder it to evade detection and pay kickbacks to his co-schemers. Today’s sentencing sends a strong message to anyone considering defrauding health care benefit programs that the federal government is actively seeking fraudulent claims and will pursue prosecution.”
From May 2022 to April 2023, Monte Vista billed Medi-Cal approximately $269,120,829 and received roughly $178,746,556 in payments for the scheme drugs. Prosecutors say Randall laundered proceeds through third parties to conceal transfers and to pay kickbacks that promoted the fraud and hid its trail from authorities.
Randall admitted he committed the offense while out on release in a separate federal tax case. In his plea agreement he agreed to forfeit assets tied to the fraud, including bank balances exceeding $17 million, three vehicles, seven properties, and high-value sports memorabilia such as Mickey Mantle and Jackie Robinson baseball cards and Kobe Bryant sneakers.
Kyrollos Mekail pleaded guilty in August 2024 to two counts of healthcare fraud and is awaiting sentencing. Patricia Anderson faces two counts of healthcare fraud and remains charged, and a criminal complaint was filed against Christina Mareik, also known as “Christina Marie Sanchez Hernandez,” alleging she created fraudulent prescriptions used in the scheme; that case is pending as well.
The investigation was led by HHS-OIG, the FBI, and the California Department of Justice. Assistant United States Attorney Roger A. Hsieh and Trial Attorney Siobhan M. Namazi prosecuted the case, with Assistant United States Attorney James E. Dochterman handling asset forfeiture matters.
The Department of Justice announced the creation of the National Fraud Enforcement Division on April 7 to centralize fraud prosecutions, aligning with a presidential task force aimed at eliminating waste and abuse in federal benefit programs. The DOJ’s Health Care Fraud Strike Force Program has charged more than 6,200 defendants who billed federal healthcare programs and private insurers over $45 billion since 2007, and agencies continue to push for stronger provider accountability.
