A man in Orange County, California, pleaded guilty to orchestrating a scheme to steal $270 million in bogus Medi-Cal claims in 11 months, the DOJ announced on Tuesday.
“Paul Richard Randall, 66, of Orange, pleaded guilty Monday to one count of wire fraud committed while on release. He has been in federal custody since June 2025,” the DOJ said.
According to federal prosecutors, Randall and others, through a business called Monte Vista Pharmacy, submitted claims for expensive prescription drugs that contained generic ingredients that were “not medically necessary.”
Monte Vista Pharmacy billed Medi-Cal millions of dollars a month after it suspended its requirement that healthcare providers “obtain prior authorization before providing certain health care services or medications as a condition of reimbursement,” the DOJ said.
Medi-Cal suspended the prior authorization as it transitioned to a new payment system.
Of the $270 million that was billed to Medi-Cal, Randall and his co-conspirators received $178 million.
Randall and the other defendants laundered the money by transferring the funds to a third party to pay “kick backs” to Patricia Anderson, 58, of West Hills.
Randall is facing up to 30 years in federal prison.
“This defendant used a public health program as his personal piggy bank,” said First Assistant U.S. Attorney Bill Essayli. “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.”
“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,” Blanche added.
“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,” he said.
“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,” he said.
The post SoCal: Orange County Man Pleads Guilty to Submitting $270 Million in Fraudulent Claims to Medi-Cal in 11 Months: DOJ appeared first on The Gateway Pundit.