An Orange County man pleaded guilty today to a federal charge for his role in a health-care fraud operation that involved submitting over $270 million in phony claims to Medi-Cal for pricey prescription pharmaceuticals that were unnecessary and, in many cases, never given.
Paul Randall, 66, of Orange, pleaded guilty in downtown Los Angeles to one count of health-care fraud.
A sentencing date of August 3 has been planned.
Randall’s plea hearing had been postponed three times due to his unavailability, according to court records.
According to an affidavit filed in Los Angeles federal court, Randall, Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 58, of West Hills, took advantage of Medi-Cal’s suspension of the requirement for caregivers to obtain prior authorization before providing certain services or medications as a condition of reimbursement.
The requirement was suspended as part of the transition of Medi-Cal’s prescription drug program to a new payment system.
According to prosecutors, Randall and accomplices took advantage of Medi-Cal’s prior permission suspension by charging the program tens of millions of dollars each month for distributing high-reimbursement, non-contracted generic medications.
According to federal authorities, several prescription drugs reportedly used to relieve pain included Folite tablets, an over-the-counter vitamin.
Normally, high-cost reimbursement prescriptions would have required prior authorization under Medi-Cal’s previous payment structure. According to the US Department of Justice, the medication used in this scheme was medically unnecessary, frequently not administered to patients, and obtained through bribes.
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