How a California crook committed $178 million worth of health care fraud — in just one year
Medications billed to Medi-Cal were either unnecessary, never provided, or both.
A California man pleaded guilty on Monday to stealing millions of dollars in taxpayer funds through his participation in a prescription drug fraud scheme, the Department of Justice reported.
Paul Richard Randall, a 66-year-old man from Orange County, has admitted to submitting nearly $270 million in fraudulent claims to Medi-Cal, California’s version of the federal Medicaid program, from May 2022 to April 2023.
'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.'
As part of his plea agreement, Randall confessed that he and his alleged accomplices took advantage of Medi-Cal by exploiting a policy change. The government program suspended the requirement for health care providers to obtain prior authorization before delivering services and medications for reimbursement while transitioning its prescription drug program to a new payment system.
Randall billed Medi-Cal millions of dollars each month for dispensing high-reimbursement, non-contracted, generic drugs through a pharmacy, including some pain medications. One such medication was Folite tablets, a vitamin available over the counter.
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