Tag: welfare

SoCal: Orange County Man Pleads Guilty to Submitting $270 Million in Fraudulent Claims to Medi-Cal in 11 Months: DOJ

A man in Orange County, California, pleaded guilty to orchestrating a scheme to steal $270 million in bogus Medi-Cal claims in 11 months, the DOJ announced on Tuesday.

“Paul Richard Randall, 66, of Orange, pleaded guilty Monday to one count of wire fraud committed while on release. He has been in federal custody since June 2025,” the DOJ said.

According to federal prosecutors, Randall and others, through a business called Monte Vista Pharmacy, submitted claims for expensive prescription drugs that contained generic ingredients that were “not medically necessary.”

Monte Vista Pharmacy billed Medi-Cal millions of dollars a month after it suspended its requirement that healthcare providers “obtain prior authorization before providing certain health care services or medications as a condition of reimbursement,” the DOJ said.

Medi-Cal suspended the prior authorization as it transitioned to a new payment system.

Of the $270 million that was billed to Medi-Cal, Randall and his co-conspirators received $178 million.

Randall and the other defendants laundered the money by transferring the funds to a third party to pay “kickbacks” to Patricia Anderson, 58, of West Hills.

Randall is facing up to 30 years in federal prison.

“This defendant used a public health program as his personal piggy bank,” said First Assistant U.S. Attorney Bill Essayli. “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.”

“Thanks to the leadership of President Donald Trump, the Department, working closely with the Task Force to Eliminate Fraud, is supercharging efforts to take down every fraudster and bring them to justice,” said Acting Attorney General Todd Blanche.

“In one day, the Department prosecuted the theft of a half-billion in taxpayer dollars. All those ripping off the American people are on notice,” Blanche added.

“The defendant was a repeat fraudster who caused Medi-Cal, a program designed to help those in need, to be billed nearly $270 million for expensive and medically unnecessary medications,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division.

“He and his co-schemers stole over $178 million through false and fraudulent claims for these medications, lining their own pockets with public funds. The Criminal Division will aggressively prosecute those who defraud Medicaid and exploit taxpayer-funded benefit programs,” he said.

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Trump Admin Busts Open Gavin Newsom’s $146 BILLION Medi-cal FRAUD Machine

Fox News just laid bare the staggering scale of waste, fraud, and abuse plaguing California’s Medi-Cal program under Governor Gavin Newsom.

In a hard-hitting segment, Kayleigh McEnany highlighted the eye-watering numbers: $146 billion per year lost to fraud in the state’s Medicaid expansion.

“That is slightly more than Warren Buffett’s estimated net worth. It is more than the GDP of several small countries,” McEnany stated.

The revelation comes as the Trump administration ramps up its nationwide assault on entitlement fraud through the White House Anti-Fraud Task Force and aggressive oversight by Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz.

Oz didn’t hold back when asked about the bigger picture.

“How big do you think this fraud is nationwide?” McEnany pressed.

“We believe nationwide it’s $100 billion in Medicare and Medicaid,” Oz replied. “If you’re worried about Medicare being there for you… and you’re worried that it’s going to expire… This fraud, getting rid of it, will DOUBLE the life expectancy of the Medicare trust fund.”

He added, “That’s a massive increase in numbers of years of extra Americans can trust that the program will be there for them.”

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Trump says workers must pay for imperialist war with cuts to Medicare, Medicaid and daycare

Speaking at a closed Easter lunch at the White House on Wednesday, US President Donald Trump declared that the federal government should stop paying for daycare, Medicare and Medicaid, all of which, he indicated, must be sacrificed for imperialist war.

“Don’t send any money for daycare,” Trump said, because “we’re fighting wars.” He went on, “You gotta let states take care of daycare and they should pay for it too … Medicaid, Medicare, all these individual things,” insisting that Washington had to concern itself with only “one thing, military protection.”

He added that the federal government’s role was to “guard the country,” before dismissing Social Security, which serves more than 70 million people; Medicare, which covers about 68 million; and Medicaid and CHIP (the Children’s Health Insurance Program), which together cover more than 75 million people, including about 36 million children, as “little scams.”

The remarks, delivered in a setting where Trump evidently felt free to speak more openly than usual, were a blunt threat against programs on which millions of workers and their family members depend. Capitalist politicians generally avoid such direct attacks on Medicare, Medicaid and Social Security because these programs remain deeply embedded in the lives of working people who have paid into them for decades. Trump, however, stated with unusual candor the real priorities of the ruling class.

The significance of the remarks lies not only in their content but in the circumstances under which they were made. The Easter lunch was closed to the press, and video of the event was briefly posted by the White House and then deleted. In contrast to Trump’s later scripted primetime address on Iran, the lunch exposed a more direct statement of policy: Social spending is to be gutted, while war spending is treated as the only indispensable function of the state.

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Minnesota Judge Hands Somali Fraudster Just 6 Months After $500K Theft in Child Food Scam

A fraudster in the massive “Feeding Our Future” scandal has received just six months in jail after stealing nearly half a million dollars in taxpayer money meant for children.

Zamzam Jama was sentenced to six months behind bars and ordered to repay $491,000 for her role in the scheme.

The sentence was handed down by U.S. District Judge Nancy Brasel, who was somehow appointed by President Trump back in 2018, one day after a co-conspirator received only a one-year term.

Brasel has previously ruled in favor of mail-in voting and counting ballots days or even weeks after an election has concluded. Mail-in ballots are the most common method that Democrats use to cheat.

The case involves one of the largest fraud operations in recent U.S. history.

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Forget Minnesota – The Amount Of Fraud Uncovered In California Is Staggering

California is a cash machine. The state collects some of the country’s highest income, business, and fuel taxes, and now spends more than $300 billion per year. And yet, everywhere you look, California seems to be falling apart.

The roads are crumbling. Mismanaged wildfires have turned neighborhoods into ash. Drug addiction and homelessness have metastasized, turning parts of Los Angeles and San Francisco into no-go zones. And the cost-of-living crisis is pricing middle-class taxpayers out of basic necessities like groceries and gas, even as the state spends billions on welfare programs that never seem to lift anyone out of poverty.

Californians are beginning to ask: Where is all this money going? On paper, it funds hospitals, universities, schools, prisons, infrastructure, and other public services. But beneath the surface, something else is happening that California Governor Gavin Newsom does not want you to see: massive, systematic, brazen fraud.

We conducted interviews with public officials, fraud experts, and political figures, and reviewed hundreds of pages of government reports, state audits, criminal indictments, and other public records on California fraud. From unemployment insurance and Medicaid to failed homeless initiatives and welfare programs, seemingly every state program has been compromised by criminals. The best estimates suggest that, on the governor’s watch, fraudsters, scammers, and organized crime rings have stolen at least $180 billion from taxpayers.

Welcome to Gavin Newsom’s empire of fraud.

Fourteen months after Newsom began his first term as governor of California, the Covid-19 pandemic swept the world. Roughly 2.7 million Californians eventually lost their jobs. The state’s economy went into freefall as its leaders imposed some of the country’s most restrictive public-health measures. In response to the crisis, Newsom sought to dump pallets of cash across the state—as quickly as possible.

One way to inject money was through California’s massive unemployment insurance program (UI). Unemployment insurance is administered by the state’s Employment Development Department (EDD), which can process billions of dollars in payments monthly. Before the state turned on the cash machine, however, experts had warned that the system was ripe for fraud.

Haywood Talcove, one of America’s leading fraud specialists and CEO of LexisNexis Risk Solutions for Government, was one such expert. “I was begging [federal officials] not to let the money go out like that, because it was going to be the biggest fraud in the history of our country,” he said. “Obviously, I wasn’t successful.”

For many reasons, California was particularly susceptible to the large-scale fraud schemes Haywood Talcove saw on the horizon. Not only did the state have some of the most generous welfare programs in the country; its bureaucrats had also failed to implement some basic fraud controls during Newsom’s tenure.

“They literally suspended all of the rules for the [unemployment insurance] program,” Talcove said. “[That made] it possible for anyone to get that benefit even if they weren’t entitled to it. It was very intentional. They knew what they were doing. But it caught up to them because it just got so out of control.”

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One of the California Hospices Targeted in Fraud Sting Had a Survival Rate of 97 Percent

One of the hospices targeted in ‘Operation Never Say Die’ today had a survival rate of nearly 100 percent. It’s amazing that these people got away with this for as long as they did.

People check into hospices to die. It’s extremely rare that someone leaves on their feet. At this place, 97 percent of the patients lived. That is a statistical impossibility.

Just imagine how much more of this there is out there.

CBS News reports:

Hospice with 97% survival rate accused of defrauding Medicare for $7.45M

The FBI arrested a married couple Thursday accused of fraudulently billing Medicare for $7.45 million while running a hospice with a survival rate reported to be more than 97% after five years. They were the first in a series of arrests planned Thursday, federal officials told CBS News.

A high survival rate at a hospice provider is one of a series of red flags identified by state auditors for fraud because most people enter hospice care in the final stages of a terminal illness. In past cases of fraud, operators were found to be using false or stolen identities to collect federal reimbursements for palliative care.

The targets of the early morning operation were Gladwin and Amelou Gill, a doctor and psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI.

The FBI raid took place in the residential neighborhood of San Dimas, California, as FBI SWAT personnel announced over a loud speaker they have an arrest warrant. CBS News was at the Southern California location when the FBI agents executed the first early morning arrests. Also on the scene was Dr. Mehmet Oz, the Trump-appointed official who oversees the federal Medicare system.

The Justice Department later announced that eight people, including the Gills, had been arrested and federally charged in connection with a health care and hospice fraud investigation.

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Judge Rejects Anti-Marijuana Groups’ Motion To Block CBD And THC Medicare Coverage Plan, Setting Hearing For 4/20

A federal judge has denied a request from a coalition of anti-marijuana organizations that sought to immediately block the Trump administration’s initiative to cover hemp-derived CBD and THC products through Medicare from launching on Wednesday.

The groups’ overall lawsuit challenging the policy is still under consideration, however, with a hearing on their separate motion for a preliminary injunction scheduled for April 20, which coincidentally is known as the unofficial cannabis cultural holiday 4/20.

Judge Trevor N. McFadden on Tuesday rejected the request from Smart Approaches to Marijuana (SAM) and nine other drug prevention groups to issue a temporary restraining order to halt the federal cannabis initiative, which is being facilitated by the Centers for Medicare & Medicaid Services (CMS), from taking effect.

McFadden, in his one-page order, quoted case law holding that a temporary restraining order is an “extraordinary and drastic remedy” that can only be granted if a party makes a “clear showing that four factors, taken together, warrant relief: likely success on the merits, likely irreparable harm in the absence of preliminary relief, a balance of the equities in its favor, and accord with the public interest.”

“Having considered the arguments in Plaintiffs’ motion and at a motions hearing, the Court finds that Plaintiffs have not met this high standard,” the judge wrote. “The motion for a temporary restraining order is thus denied. The Court will consider Plaintiffs’ motion for a preliminary injunction and motion to stay upon the completion of briefing.”

Defendants in the lawsuit—CMS Administrator Mehmet Oz and U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr.—now have until April 9 to file briefs responding to the prohibitionist groups’ motion for a preliminary injunction. The plaintiffs then have a reply brief due on April 13, a week ahead of the 4/20 hearing on the matter.

The lawsuit comes as CMS is set to start covering CBD and THC products under select federal health insurance programs as a Substance Access Beneficiary Engagement Incentive (BEI) beginning on Wednesday.

Under the BEI, patients enrolled in specific federal health insurance programs could have up to $500 worth of hemp-derived products covered each year. The CBD-focused plan will also allow a certain amount of THC in products, but the agency said that the rules are subject to change if federal hemp policy changes, as is currently expected under a law set to take effect later this year.

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New Restrictions On SNAP Purchases To Take Effect In More States In April

Food stamp recipients in Florida, Texas, and West Virginia will face restrictions on buying certain kinds of less nutritious items such as soda and candy, some starting in April.

West Virginia’s restrictions became effective on Jan. 1, but retailers have until April 1 to be fully compliant.

The U.S. Department of Agriculture (USDA) has approved Colorado’s restrictions waiver, but the state has delayed implementation of restrictions on certain items for food stamp recipients until after April 30 and stated that it would have a final vote on April 3 on the program.

The Trump administration is clamping down on soda and candy being charged to food stamps, as 22 states now have been approved to restrict certain purchases under the program. The restrictions still require state approval before taking effect.

Kansas, Nevada, Ohio, and Wyoming were the latest states to receive USDA approval for food and beverage restrictions.

The Supplemental Nutrition Assistance Program (SNAP), also known as food stamps, had 40.7 million people participating nationwide at a monthly cost of $7.97 billion as of November 2025.

“The Trump Administration is leading bold reform to strengthen integrity and restore nutritional value within the Supplemental Nutrition Assistance Program,” the USDA stated on its website. “USDA is empowering states with greater flexibility to manage their programs by approving SNAP Food Restriction Waivers that restrict the purchase of non-nutritious items like soda and candy. These waivers are a key step in ensuring that taxpayer dollars provide nutritious options that improve health outcomes within SNAP.”

For example, starting on April 1, Texas residents will not be able to buy candy or sweetened drinks on their SNAP-provided Lone Star Cards. Those restrictions will ban such purchases as candy bars, gum, and taffy, as well as nuts, raisins, or fruits that have been “candied, crystallized, glazed or coated with chocolate, yogurt or caramel.”

Texas also will ban sweetened non-alcoholic beverages made with water that contain 5 or more grams of sugar or artificial sweetener, according to Texas Health and Human Services.

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Anti-Marijuana Groups File Lawsuit To Block Trump Administration’s Hemp CBD And THC Medicare Coverage Plan

A coalition of anti-marijuana organizations is suing the Trump administration over a novel initiative set to launch this week to widen the availability of CBD and THC for certain patients by covering hemp-derived products under select federal health insurance programs.

Smart Approaches to Marijuana (SAM) and nine other drug prevention groups on Monday filed a lawsuit in the U.S. District Court for the District of Columbia, challenging the legality of the cannabis program—which is being facilitated by the Centers for Medicare & Medicaid Services (CMS)—and seeking a temporary restraining order to immediately halt the process.

The filing names CMS Administrator Mehmet Oz and U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. as defendants in the lawsuit. The lawsuit comes as CMS is set to start covering CBD and THC products as a Substance Access Beneficiary Engagement Incentive (BEI) beginning on Wednesday.

Under the BEI, patients enrolled in specific federal health insurance programs could have up to $500 worth of hemp-derived products covered each year. The CBD-focused plan will also allow a certain amount of THC in products, but the agency said earlier this month the rules are subject to change if federal hemp policy changes, as is currently expected under a law set to take effect later this year.

SAM and the other organizations—including the Cannabis Impact Prevention Coalition, Drug Free American Foundation and Save Our Society From Drugs—made several arguments in support of legal intervention to prevent the cannabidiol BEI from moving forward. Much of the complaint focuses on alleged violations of administrative rules to provide the treatment, which they point out has not received Food and Drug Administration (FDA) approval.

CMS didn’t publish a notice of proposed rulemaking for the cannabis BEI that would have afforded the public with a comment period to weigh in, and the agency’s initiative runs counter to a separate final rule it issued last year that “declared cannabis products ineligible for supplemental Medicare coverage for chronically ill patients,” the prohibitionist plaintiffs said.

Beyond those alleged violations of the Administrative Procedure Act (APA), the groups noted that CMS described a BEI for CBD containing a maximum THC concentration that exceeds what would constitute federally legal hemp under a policy that’s set to be implemented in November.

The filing says the program would additionally violate the Social Security Act (SSA), which “does not allow CMS to sanction the possession and use of illegal and dangerous Schedule I substances by Medicare patients without clear congressional authorization.”

“CMS’s action represents an unprecedented and unlawful assertion of binding decision-making authority that will profoundly affect the health of elderly Americans,” SAM and the other organizations said in their complaint. “CMS took this action without the guardrails imposed by the administrative process, without any reasoned explanation, in conflict with the agency’s own recent APA-compliant determination, and without statutory authority.”

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Migrant Households Are Claiming £1 Billion a MONTH in UK Welfare Benefits.

Foreign nationals are claiming close to £1 billion (~$1.3 billion) in welfare payments from the British government each month, according to the latest Department for Work and Pensions (DWP) figures. The data, released in response to Freedom of Information requests from Conservative (Tory) Member of Parliament (MP) Neil O’Brien, shows that households containing at least one foreign national received £941 million in Universal Credit payments this month.

Universal Credit, which supports low-income working-age families, is available to migrants who hold Indefinite Leave to Remain (ILR)—roughly equivalent to permanent residency in the U.S.—or refugee status. Over the last four years, the total value of claims from households with a migrant has more than doubled, climbing from £461 million in March 2019 to almost £1 billion now. The figure rose by nearly 30 per cent in the past 12 months alone.

Neil O’Brien criticized the trend, saying: “The growth of benefit spending and the rate of migration are both much too fast, and the Government is doing far too little to change either trend. Migrants know that if they can make it to the UK, they will be allowed to stay. As long as that is true, we’ll see more and more coming. Our soft-touch welfare state makes this worse.”

Reform Party leader Nigel Farage has called for the complete abolition of Indefinite Leave to Remain as a way to reduce the financial strain of large-scale migration. Reform wants to restrict welfare benefits to British citizens only and replace Indefinite Leave to Remain with a five-year work visa system modelled on the American approach to long-term legal immigration.

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