California man sentenced to 30 years in $270M Medi-Cal scheme; AI-designed proteins outperformed an approved CAR T; brain monitoring without the gel — Morning Medical Update

California man sentenced to 30 years in $270M Medi-Cal scheme

Paul Richard Randall billed Medi-Cal more than $269 million in 11 months after the program suspended prior authorization.

Paul Richard Randall, 67, of Orange, California, was sentenced Sept. 9 to 360 months in federal prison and ordered to pay $178,746,556 in restitution, the U.S. Attorney's Office for the Central District of California announced. Randall pleaded guilty April 7 to one count of wire fraud committed while on release in a separate federal tax case.

Prosecutors said Randall and two co-schemers exploited Medi-Cal's temporary suspension of prior authorization requirements, billing through Monte Vista Pharmacy for 19 high-reimbursement, non-contracted generic drugs that were medically unnecessary, never dispensed or both. One was Folite, a vitamin available over the counter. The pharmacy billed more than $269 million from May 2022 to April 2023 and was paid more than $178 million. One co-defendant awaits sentencing; charges against two others are pending.

AI-designed proteins outperformed an approved CAR T

The binders, built from scratch, controlled tumor growth in mice better than those in an FDA-approved product.

Only about 4% of U.S. patients with advanced or metastatic cancer are candidates for CAR T-cell therapy, and closer to 3% benefit. A Memorial Sloan Kettering Cancer Center team used generative artificial intelligence to design the "binders" that let engineered T cells recognize a tumor, rather than repurposing existing antibodies. Against BCMA, a multiple myeloma target, the AI-designed binder controlled tumor growth in mice better than the binder in an FDA-approved product.

The proof-of-concept study, published Sept. 9 in Nature Biomedical Engineering, is preclinical. The models failed against the target CD19, and one CD22 binder activated against healthy cells until the team corrected it. Caleb Lareau, Ph.D., who leads the lab, said the approach could eventually yield therapies for rare cancers in weeks. MSK has filed a provisional patent, and Lareau consults for a biotechnology company.

Brain monitoring without the gel

Six embroidered electrodes in a neoprene headband matched a commercial EEG cap at the group level.

Conventional electroencephalography means bulky hardware, electrolyte gel, long setup and sometimes skin irritation, which limits monitoring outside a lab. Researchers in Ireland and Italy built a neoprene headband with six embroidered textile electrodes that need no gel and no skin preparation. Fitting took about five minutes, compared with 10 to 15 minutes of scalp preparation for the commercial sponge-based cap it was tested against.

In 10 healthy adults, the headband detected alpha-band changes between eyes open and closed and event-related potentials in auditory and visual oddball tasks, performing comparably to the commercial system at the group level. Nine of 10 participants reported no skin irritation. The authors call the device a proof of concept and caution that agreement between the two systems was weak on some individual measures and that a 10-person sample limits generalizability. The study appeared Sept. 9 in PLOS One.