Orange County Pharmacy Operator Pleads Guilty to $270 Million Medi-Cal Fraud Built on Prior Authorization Loophole

Orange County pharmacy operator Paul Richard Randall pleaded guilty April 6 to submitting nearly $270 million in fraudulent Medi-Cal claims, the latest in a wave of California healthcare fraud cases.

Orange County Pharmacy Operator Pleads Guilty to $270 Million Medi-Cal Fraud Built on Prior Authorization Loophole Orange County pharmacy operator Paul Richard Randall pleaded guilty April 6 to submitting nearly $270 million in fraudulent Medi-Cal claims, the latest in a wave of California healthcare fraud cases. Aaron Rafferty April 12, 2026 Key Takeaways: Paul Richard Randall, 66, of Orange, pleaded guilty on April 6 to one count of wire fraud for submitting approximately $269,120,829 in fraudulent Medi-Cal claims, on which the program paid out approximately $178,746,556 over 11 months. Randall and co-conspirators operated through Monte Vista Pharmacy and exploited Medi-Cal's temporary suspension of prior authorization requirements, billing for expensive non-contracted generic medications that were medically unnecessary and in many cases never dispensed. Randall was a repeat fraudster, having been convicted in 2012 for a hospital kickback scheme paying doctors and chiropractors up to $20,000 per spinal surgery referral. He has been in federal custody since June 2025 and faces up to 30 years at his August 3 sentencing. Randall pleaded guilty in downtown Los Angeles to a single count of wire fraud committed while on release, according to a Department of Justice announcement . His plea hearing had been postponed three times previously due to his unavailability. From May 2022 to April 2023, Randall ran Monte Vista Pharmacy along with co-conspirators Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 58, of West Hills. Mekail pleaded guilty in August 2024 to two counts of health care fraud and awaits sentencing. Anderson is charged with two counts of health care fraud. "This defendant used a public health program as his personal piggy bank," said First Assis