Cave Consulting Group, LLC v. Optuminsight, Inc.

CourtCourt of Appeals for the Federal Circuit
DecidedMarch 21, 2018
Docket17-1060
StatusUnpublished

This text of Cave Consulting Group, LLC v. Optuminsight, Inc. (Cave Consulting Group, LLC v. Optuminsight, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Federal Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cave Consulting Group, LLC v. Optuminsight, Inc., (Fed. Cir. 2018).

Opinion

NOTE: This disposition is nonprecedential.

United States Court of Appeals for the Federal Circuit ______________________

CAVE CONSULTING GROUP, LLC, Plaintiff-Appellee

v.

OPTUMINSIGHT, INC., FKA INGENIX, INC., Defendant-Appellant ______________________

2017-1060 ______________________

Appeal from the United States District Court for the Northern District of California in No. 5:11-cv-00469-EJD, Judge Edward J. Davila. ______________________

Decided: March 21, 2018 ______________________

RICHARD L. BROPHY, Armstrong Teasdale LLP, St. Louis, MO, argued for plaintiff-appellee. Also represented by ZACHARY CHARLES HOWENSTINE, MARK A. THOMAS.

PETER MCCREERY LANCASTER, Dorsey & Whitney LLP, Minneapolis, MN, argued for defendant-appellant. Also represented by SHANNON L. BJORKLUND, TIMOTHY J. DROSKE; PAUL D. ACKERMAN, Andrews Kurth Kenyon LLP, New York, NY; EDWARD R. REINES, Weil, Gotshal & Manges LLP, Redwood Shores, CA. 2 CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC.

______________________

Before LOURIE, DYK, and TARANTO, Circuit Judges. LOURIE, Circuit Judge. OptumInsight, Inc. (“Optum”) appeals from the final judgment by the United Stated District Court for the Northern District of California. See Cave Consulting Grp., LLC v. OptumInsight, Inc., No. 5:11-cv-00469-EJD (N.D. Cal. Apr. 6, 2015), ECF No. 370; J.A. 1. The judg- ment follows a jury verdict in favor of Cave Consulting Group, LLC (“Cave”) that U.S. Patent 7,739,126 (“the ’126 patent”) is not invalid and was infringed by Optum, awarding Cave $12,325,000 in damages. See Cave Con- sulting Grp., LLC v. OptumInsight, Inc., No. 5:11-cv- 00469-EJD (N.D. Cal. Apr. 3, 2015), ECF No. 366; J.A. 81–85. On appeal, Optum challenges the district court’s vari- ous rulings, including a claim construction order, see Cave Consulting Grp., LLC v. Ingenix, Inc., No. 5:11-cv-00469- EJD, 2013 WL 2467930 (N.D. Cal. June 7, 2013) (“Claim Construction Order”), orders on summary judgment motions, see Cave Consulting Grp., LLC v. OptumInsight, Inc., No. 5:11-cv-00469-EJD, 2015 WL 740379 (N.D. Cal. Feb. 20, 2015) (“SJ Order”); Cave Consulting Grp., LLC v. OptumInsight, Inc., No. 5:11-cv-00469-EJD (N.D. Cal. Feb. 23, 2015), ECF No. 293; J.A. 77–79, an order on Daubert motions, see Cave Consulting Grp., LLC v. Op- tumInsight, Inc., No. 5:11-cv-00469-EJD, 2015 WL 13413389 (N.D. Cal. Feb. 20, 2015) (“Daubert Order”), an order on certain pre-trial motions, see Cave Consulting Grp., LLC v. OptumInsight, Inc., No. 5:11-cv-00469-EJD (N.D. Cal. Mar. 16, 2015), ECF No. 332; J.A. 80, and an order on motion for judgment as a matter of law (“JMOL”) or for a new trial, see Cave Consulting Grp., LLC v. Op- tumInsight, Inc., No. 5:11-cv-00469-EJD, 2016 WL 4658979 (N.D. Cal. Sept. 7, 2016) (“Post-trial Order”). CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC. 3

Because the district court erred in its claim construction, we reverse in part, vacate in part, and remand. BACKGROUND Cave owns the ’126 patent, which discloses “[a] meth- od for measuring physician efficiency and patient health risk stratification.” ’126 patent Abstract. The ’126 patent describes that a physician’s “efficiency,” i.e., the cost of care by a physician compared to that of a peer group, can be determined by analyzing relevant medical claims data. Id. col. 1 ll. 13–46, col. 7 l. 4–col. 9 l. 26. Independent claims 22 and 29 are at issue in this appeal; claim 22 reads as follows: 22. A method implemented on a computer system of determining physician efficiency, the method comprising: obtaining medical claims data stored in a computer readable medium on the com- puter system; performing patient analysis using said ob- tained medical claims data to form epi- sodes of care utilizing the computer system; performing output process based on per- formed patient analysis utilizing the com- puter system, the output process comprising: assigning episodes of care to phy- sicians; and applying a first maximum dura- tion rule to identify episodes of care; assigning at least one physician to a re- port group utilizing the computer system; 4 CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC.

determining eligible physicians and epi- sode of care assignments utilizing the computer system; calculating condition-specific episode of care statistics utilizing the computer sys- tem; calculating weighted episode of care statis- tics across medical conditions utilizing a predefined set of medical conditions for a specific specialty type utilizing the com- puter system; and determining efficiency scores for physi- cians from said calculated condition- specific episode of care statistics and said weighted episode of care statistics calculat- ed across medical conditions utilizing the computer system. Id. col. 111 l. 55–col. 112 l. 14 (emphases added). Similarly, claim 29 requires “[a] computer program product” that “perform[s] the acts of” the identical steps of the method delineated in claim 22. Id. col. 112 ll. 38–67. The ’126 patent describes its method as employing what it calls a “marketbasket” based on physicians’ spe- cialties and discloses calculating “weighted episode statis- tics” of a peer group and of a physician to determine the physician’s efficiency score. Id. col. 92 l. 27–col. 94 l. 47. In particular, the ’126 patent describes that according to its method of using the “marketbasket,” “regardless of a physician’s (or peer group’s) actual episode work effort, the rule standardizes each physician’s actual work effort to a static set of weight factors,” and that its method “allows for an apples-to-apples comparison of one physi- cian’s marketbasket results to another physician’s mar- ketbasket results.” Id. col. 73 ll. 51–53, 57–61. The patent further states that its calculation of “weighted CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC. 5

episode statistics” using the “marketbasket” is “referred to as the indirect standardization rule” and that “[t]he system of the present invention uses an indirect standard- ization technique for weighting together the episodes within the core group of medical conditions.” Id. col. 92 ll. 37–41. As background, the ’126 patent discusses the prior art methods that “use a physician’s actual episode composi- tion.” Id. col. 1 ll. 50–51. The patent further discusses, inter alia, a type of measurement error, which “occurs in most if not all current efficiency measurement systems, occurs when the physician’s actual episode composition is used.” Id. col. 2 ll. 32–34. On the other hand, the patent states that, in calculating a peer group’s “weighted epi- sode statistics,” its method “does not use the peer group’s actual episode composition to calculate the weighted average. Instead, the predetermined standard market- basket weights are used.” Id. col. 93 ll. 12–14. Similarly, in calculating an individual physician’s “weighted episode statistics,” the patent states that “the same indirect standardization weighting calculations are performed using the physician’s condition-specific utilization and charges per episode and the same specialty-specific mar- ketbasket weights.” Id. col. 93 ll. 31–35. In 2011, Cave filed suit against Ingenix, Inc., Optum’s predecessor, in the Northern District of California, alleg- ing infringement of the ’126 patent. Optum counter- claimed, asserting its own patents against Cave. They were found not to have been infringed and that issue is not before us in this appeal. It is undisputed that Cave and Optum both develop and market software and ser- vices that are used to measure efficiency of healthcare providers. Appellant’s Br. 3–4; Appellee’s Br. 2–3. In August 2012, the district court held a claim con- struction hearing. In June 2013, the court issued an order construing, inter alia, certain claim limitations of 6 CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC.

the ’126 patent. See Claim Construction Order, 2013 WL 2467930.

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