A California man pleaded guilty yesterday to submitting nearly $270 million in fraudulent claims over an 11-month span to California’s Medicaid program (Medi-Cal) for expensive prescription drugs that were medically unnecessary and, in many instances, not provided to the purported recipients.
The Department of Justice announced this case and two others in support of President Trump’s Task Force to Eliminate Fraud at a press conference in Washington today.
“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 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 of the Justice Department’s Criminal Division. “He and his co-schemers stole over $178 million through false and fraudulent claims for these medications, lining their own pockets with public funds. The Criminal Division will aggressively prosecute those who defraud Medicaid and exploit taxpayer-funded benefit programs.”
“This defendant used a public health program as his personal piggy bank,” said First Assistant U.S. Attorney Bill Essayli of the Central District of California. “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.”
“Schemes that bill Medicaid for costly drugs that patients never needed or received threaten the integrity of the program,” said Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). “This plea shows our firm resolve, alongside our law enforcement partners, to exposing such fraud operations, ensuring those responsible are held accountable, and safeguarding taxpayer-funded health care programs.”
According to court documents, Paul Randall, 66, of Orange, along with pharmacist and pharmacy owner Kyrollos Mekail, 37, of Moreno Valley, and nurse practitioner Patricia Anderson, 58, of West Hills, exploited Medi-Cal’s suspension of its requirement that health care providers obtain prior authorization before providing certain medications at the beginning of 2022. Medi-Cal temporarily suspended the requirement as part of a transition to a new payment system. Using a business called Monte Vista Pharmacy, which Mekail owned, Randall and his co-schemers billed Medi-Cal tens of millions of dollars per month for purportedly dispensing high-reimbursement drugs containing cheap, generic ingredients that were manufactured in unique dosages, combinations or package quantities and were not included in the applicable maximum price lists that cap Medi-Cal reimbursements.
In furtherance of the scheme, Randall paid illegal kickbacks to patient marketers in exchange for Medi-Cal beneficiary information and thereafter paid illegal kickbacks to Anderson to sign pre-filled prescriptions for 19 high-reimbursement, non-contracted, generic drugs. Anderson never met the patients, reviewed their medical records or otherwise determined that the medications were medically necessary before signing the prescriptions. 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.
Randall received a portion of Monte Vista’s reimbursements from Medi-Cal, at times equaling approximately 40% of Monte Vista’s profit from the false and fraudulent claims. Randall admitted in his plea agreement that he caused at least $269,120,829 in false and fraudulent claims to Medi-Cal from May 2022 to April 2023, of which Medi-Cal paid at least approximately $178,746,556. Randall also admitted that he committed the offense while on release in another criminal case.
Randall and others laundered their illicit proceeds by transferring the money to a third party to pay kickbacks to Anderson in an attempt to conceal the crime from law enforcement.
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-schemers 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.
Randall pleaded guilty to one count of wire fraud. He is scheduled to be sentenced on August 3 and faces a maximum penalty of 30 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Relatedly, in August 2024, Mekail pleaded guilty to two counts of health care fraud and awaits sentencing. In April 2025, Anderson pleaded guilty to two counts of health care fraud and also awaits sentencing.
The FBI, HHS-OIG, and the California Department of Justice are investigating the case.
Assistant Chief Niall M. O’Donnell and Trial Attorney Siobhan M. Namazi of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Roger A. Hsieh for the Central District of California are prosecuting 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.