A California man has been sentenced to 30 years in federal prison for masterminding a massive health care fraud scheme that resulted in nearly $270 million in fraudulent claims being submitted to Medi-Cal over just 11 months.

The United States Department of Justice announced the sentence on September 9, 2026. Paul Richard Randall, 67, of Orange, California, received a 360-month federal prison sentence. U.S. District Judge Mark C. Scarsi also ordered Randall to pay approximately $178.75 million in restitution.

The scheme targeted Medi-Cal, California's Medicaid programme, which provides health care coverage to eligible residents. According to court documents cited by federal authorities, Randall and his co-conspirators exploited a temporary suspension of a Medi-Cal requirement for health care providers to obtain prior authorisation before certain medications or services could qualify for reimbursement. The suspension was introduced as part of an ongoing transition of Medi-Cal's prescription drug programme to a new payment system.

Through Monte Vista Pharmacy, the scheme exploited this period by billing Medi-Cal for expensive, high-reimbursement generic medications. Authorities determined that the drugs were medically unnecessary in many cases, were not actually provided to the purported patients, or both.

One example highlighted by the Justice Department illustrates the scale of the reimbursement involved. Approximately $13,424 was billed for one prescription of 5 mg meloxicam, while the department said a 30-day supply of the generic drug in larger dosages would typically cost approximately $5 to $25. Other products involved in the scheme included pain creams and Folite tablets, a vitamin product available over the counter.

Between May 2022 and April 2023, Randall caused at least $269,120,829 in false and fraudulent claims to be submitted to Medi-Cal, according to federal authorities. Medi-Cal paid approximately $178,746,556 of those claims.

Investigators also said the operation involved illegal kickbacks. Randall allegedly paid patient marketers in exchange for Medi-Cal beneficiary information and paid nurse practitioner Patricia Anderson to sign pre-filled prescriptions. According to the Justice Department, Anderson did not meet the patients, review their medical records or determine whether the medications were medically necessary before signing the prescriptions. Randall and others also transferred proceeds from the scheme through third parties to fund kickbacks and conceal the movement of the money, according to prosecutors.

Randall pleaded guilty in April 2026 to one count of wire fraud. As part of his plea agreement, he agreed to forfeit property obtained through the fraud. US authorities say approximately $126.5 million in assets accumulated through the scheme have been seized to date. The seized assets include approximately $111 million in bank funds and securities, nine luxury vehicles worth about $1 million, nine luxury properties valued at approximately $13.5 million, and more than $1 million worth of sports memorabilia.

Federal prosecutors also said Randall committed the offence while on release in another federal criminal tax case. The investigation was conducted by the FBI, the US Department of Health and Human Services Office of Inspector General and the California Department of Justice.

The case demonstrates how vulnerabilities in public health reimbursement systems can be exploited on a very large scale. In this instance, authorities say nearly $270 million in claims were generated in less than one year.

Source consulted: California Man Sentenced to 30 Years for Orchestrating $270M Medication Reimbursement Fraud Scheme Targeting Medi-Cal | U.S. Department of Justice. The corresponding U.S. Attorney's Office for the Central District of California press release was issued on the same day, September 9, 2026.

Image credit: VOA