California Man Gets 30-Year Sentence in $270M Medi‑Cal Fraud

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  On September 9, 2026, 67-year-old Paul Richard Randall of Orange, California, was sentenced to 30 years in federal prison for masterminding a massive health care fraud scheme. The scheme targeted Medi-Cal(California's Medicaid program), resulting in nearly $270 million in fraudulent claims submitted over a mere 11-month span. 

  The sentence marks one of the highest health care fraud penalties in the history of the Central District of California. In addition to his prison term, U.S. District Judge Mark Scarsi ordered Randall to pay $178,746,556.22 in restitution. 

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  🔍 The Exploit: Gaming the System

  Between May 2022 and April 2023, Randall and his co-conspirators took advantage of a temporary vulnerability in the California health care system. Medi-Cal had briefly suspended its prior-authorization requirements for health care providers during a transition to a new prescription drug reimbursement system.

  Seeing a loophole, Randall operated through Monte Vista Pharmacy to bill the government tens of millions of dollars per month. They targeted 19 high-reimbursement, generic medications that were completely medically unnecessary, and in many instances, never even given to patients. 

  💊 $13,000 for $5 Vitamins

  The scale of the markup was staggering. The conspirators billed the state thousands of dollars per prescription for basic items. 

  • For example, a single prescription of Meloxicam (an arthritis drug that normally costs $5 to $25) was billed to the state at $13,424.
  • Other heavily billed items included basic pain creams and Folite, which is a standard over-the-counter vitamin. 

  🤝 Kickbacks and Fake Prescriptions

  To generate the massive volume of fake paperwork, Randall paid "patient marketers" to steal or buy the personal information of legitimate Medi-Cal beneficiaries. He then used illicit funds to pay hundreds of thousands of dollars in kickbacks to a nurse practitioner. The nurse pre-signed stacks of prescriptions without ever meeting the patients, reviewing their medical histories, or determining if they actually needed the drugs.

  🏎️ Sports Cards and Kobe Bryant Sneakers

  What makes Randall's case particularly egregious to federal prosecutors was his timing. He orchestrated this entire $270 million scheme while out on pre-sentencing release for a completely separate federal tax fraud case.

  As part of his plea deal, the government seized $126.5 million in assets accumulated from his crimes. The asset forfeiture included: 

  • $17 million cash across various bank accounts
  • 7 luxury properties and 3 vehicles
  • High-value sports memorabilia, including rare Mickey Mantle and Jackie Robinson baseball cards, alongside game-worn, autographed Kobe Bryant sneakers.

  Assistant Attorney General Colin M. McDonald noted that Randall deliberately exploited a safety net program to line his own pockets, stealing money "meant to help California's most vulnerable residents".