Inland Empire Pharmacist Charged with $300 Million Medi-Cal Fraud

An Inland Empire pharmacist, Kyrollos Mekail, 36, of Moreno Valley, has been charged with health care fraud by the Justice Department. Mekail, the operator of Monte Vista Pharmacy in Montclair, is accused of submitting over $300 million in fraudulent Medi-Cal claims for prescriptions that were medically unnecessary and often not provided to patients. The prescriptions were allegedly obtained through the payment of illegal kickbacks.

The U.S. Department of Health and Human Services Office of Inspector General, the FBI, and the California Department of Justice are currently investigating the case. Mekail, a licensed pharmacist, allegedly exploited Medi-Cal’s prior authorization suspension by billing the program tens of millions of dollars per month for dispensing high-reimbursement, non-contracted, generic drugs. Some of the prescriptions included painkillers and over-the-counter vitamins.

Under Medi-Cal’s old payment system, prior authorization would have been required for the medications dispensed. However, the investigation reveals that the medications involved in this scheme were medically unnecessary, frequently not dispensed to patients, and obtained through kickbacks. In less than a year, Monte Vista Pharmacy billed Medi-Cal over $306 million for these medications, of which they received more than $204 million in payments.

Investigators discovered that Mekail allegedly paid two co-schemers over $36 million in kickbacks for referring the fraudulent prescriptions. These kickbacks were disguised as payments for “consulting services.”

U.S. Attorney Martin Estrada emphasized the significance of bringing those who unlawfully take from public programs to justice, especially when they harm the most vulnerable in the community. Nicole M. Argentieri, principal deputy assistant attorney general and head of the Justice Department’s criminal division, highlighted the impact of health care fraud on all Americans, as it diverts tax dollars meant for the care of the vulnerable and disabled, ultimately raising the cost of care for everyone.