California Man Pleads Guilty to $178M Medi-Cal Fraud Scheme

Authorities say Paul Richard Randall billed Medi-Cal for expensive, non-contracted drugs with generic ingredients that were not medically necessary or provided.

Apr. 8, 2026 at 5:09pm

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An extreme close-up photograph of a stack of generic prescription drug bottles against a pitch-black background, lit by a harsh, direct camera flash, conceptually illustrating the fraud and abuse uncovered in California's Medicaid program.A recent wave of healthcare fraud in California has exposed vulnerabilities in the state's Medicaid system, leading to calls for tighter oversight and controls.Orange Today

Paul Richard Randall, 66, of Orange, California, has pleaded guilty to one count of wire fraud after authorities say he and his co-conspirators billed Medi-Cal, California's Medicaid program, more than $269 million and were paid out over $178 million for expensive generic medications that were not medically necessary or even provided. Randall and his associates then laundered the illegal proceeds and paid kickbacks to further the scheme.

Why it matters

This case highlights the ongoing issue of widespread fraud in California's healthcare system, with the state being called the 'Fraud Capital of the United States' by some critics. It also comes as the federal government has ramped up efforts to combat fraud, including through a new anti-fraud task force led by Vice President JD Vance.

The details

Randall and his co-conspirators took advantage of a temporary rule change in Medi-Cal that removed the need for pre-approval on certain drugs. Using a pharmacy they controlled, they billed Medi-Cal huge amounts each month for expensive generic medications that normally would've required approval. Randall and his associates then laundered the illegal proceeds by routing money through a third party, using it to pay kickbacks to further the scheme and hide the transactions from law enforcement.

  • In August, Randall will be sentenced and faces a statutory maximum sentence of 30 years in federal prison.

The players

Paul Richard Randall

A 66-year-old Orange, California resident who has pleaded guilty to one count of wire fraud in a $178 million Medi-Cal fraud scheme.

Bill Essayli

First Assistant U.S. Attorney who said Randall 'used a public health program as his personal piggy bank.'

JD Vance

Vice President leading the federal anti-fraud task force that has targeted California healthcare fraud.

Gavin Newsom

The Governor of California who has pushed back on criticism of fraud in the state, claiming California is 'leading the nation in preventing fraud.'

Kevin Kiley

An Independent congressman from California who stated that 'California is without question the Fraud Capital of the United States.'

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What they’re saying

“This defendant used a public health program as his personal piggy bank.”

— Bill Essayli, First Assistant U.S. Attorney

“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.”

— Bill Essayli, First Assistant U.S. Attorney

“California is without question the Fraud Capital of the United States. We are finally seeing accountability.”

— Kevin Kiley, Independent Congressman from California

What’s next

Randall will be sentenced in August and faces up to 30 years in federal prison.

The takeaway

This case highlights the ongoing battle against widespread fraud in California's healthcare system, with state and federal authorities working to crack down on schemes that have cost taxpayers hundreds of millions of dollars. It also underscores the need for stronger oversight and tighter controls to prevent such large-scale fraud from occurring in the future.