The Regulator

30: that is how many years in federal prison a Southern California pharmacy operator got this week for running nearly $270 million in fake claims through California’s Medicaid program. U.S. District Judge Mark C. Scarsi sentenced Paul Richard Randall, 67, of Orange, California, to 360 months in federal prison on September 9, 2026, and ordered him to pay $178,746,556 in restitution for a scheme in which his business, Monte Vista Pharmacy, billed Medi-Cal for high-reimbursement generic drugs that were medically unnecessary and frequently never dispensed to patients, obtained through illegal kickbacks. Prosecutors said Randall exploited a gap in Medi-Cal’s prior-authorization system to bill tens of millions of dollars a month over an 11-month span, then laundered the proceeds; the government has already seized roughly $126.5 million tied to the scheme, including $111 million in cash and securities, nine luxury vehicles, nine properties and sports memorabilia. The U.S. Attorney’s Office for the Central District of California called it one of the longest health care fraud sentences in the district’s history. Confidence: Medium-High. The Department of Justice’s own press release could not be independently retrieved this run, a recurring access issue with justice.gov noted in prior issues; this account relies on the DOJ release as quoted directly by MyNewsLA’s and the California Statewide Law Enforcement Association’s coverage of the case. Sources: Orange County Man Sentenced to 30 Years in Federal Prison for Orchestrating Massive Health Care Fraud, U.S. Department of Justice, Central District of California, OC Man Gets 30 Years for $270M Medi-Cal Fraud Scheme, MyNewsLA.

A federal appeals court in New Orleans is weighing whether Louisiana can block patients nationwide from getting the abortion pill by mail, three years after the Food and Drug Administration (FDA) dropped the rule requiring it be dispensed in person. A three-judge panel of the U.S. Court of Appeals for the Fifth Circuit, Judges Priscilla Richman, Stephen A. Higginson and Dana M. Douglas, heard oral arguments September 9, 2026 in Louisiana’s suit against the FDA over its 2023 decision allowing mifepristone, an abortion and miscarriage-management drug, to be prescribed by telehealth and delivered by mail. Louisiana and co-plaintiff Rosalie Markezich argue the change was “arbitrary and capricious” under the Administrative Procedure Act and are appealing a district court’s April 2026 refusal to block it while the case proceeds. The dispute already reached the U.S. Supreme Court once this year: the Court stayed an earlier Fifth Circuit order won by Louisiana on May 14, 2026, keeping mail delivery legal nationwide for now. Confidence: Medium-High. This run relied on the Georgetown Health Care Litigation Tracker’s docket summary and news coverage of the oral argument; the court’s own recording or transcript was not independently reviewed, and no ruling has issued yet. Sources: State of Louisiana et al. v. Food and Drug Administration et al., Georgetown Health Care Litigation Tracker, ‘Louisiana needs relief now’: Oral arguments complete in state’s abortion pill case against FDA, Live Action.

A federal watchdog says the money Congress set aside to fix drinking water and sewer systems on tribal land will not be enough to finish the job. The Department of Health and Human Services Office of Inspector General (OIG) posted a data brief September 9, 2026 on the Indian Health Service’s (IHS) Sanitation Facilities Construction program, which is using a five-year, $3.5 billion appropriation under the 2021 Infrastructure Investment and Jobs Act to build and repair drinking water, sewage and solid-waste systems for American Indian and Alaska Native homes. OIG found IHS has allocated $2.6 billion of that total toward 702 projects ready for design or construction and 233 more still in planning, and that while completing the current pipeline should cut unfunded projects by more than half, per-project costs have climbed even as the number of projects has fallen. OIG also flagged staffing and contracting shortages at IHS area offices and tribes as a barrier, and said the program’s final-year fiscal 2026 funding will not close the remaining gap. Confidence: High. This run reviewed OIG’s own report page directly. Sources: Data Brief: Snapshot of Indian Health Service Sanitation Facilities Construction Projects Funded Under the Infrastructure Investment and Jobs Act, HHS Office of Inspector General.

The federal government is adding fresh money for the nonprofit network that trains volunteers nationwide to help Medicare patients spot and report fraud, the same week this newsletter’s lead story is a nine-figure Medicaid fraud case. The Administration for Community Living (ACL) announced in a Federal Register notice published September 10, 2026 that it intends to award a single-source administrative supplement of $226,000 for fiscal year 2026 to the Northeast Iowa Area Agency on Aging, which holds the cooperative agreement for the Senior Medicare Patrol (SMP) Resource Center, bringing the center’s total fiscal 2026 award to $1,226,000. The Senior Medicare Patrol program recruits and trains volunteers to help Medicare beneficiaries recognize and report suspected fraud; ACL’s notice did not detail exactly how the supplement will be spent beyond letting the grantee expand its work. Confidence: High. This run reviewed the notice’s text via the federal government’s own Federal Register monitoring feed; the live federalregister.gov page returned a bot-verification interstitial to direct fetch this run. Sources: Announcing the Intent To Award a Single-Source Supplement to the Senior Medicare Patrol (SMP) Resource Center, Federal Register.