Cave Consulting Group, LLC v. Optuminsight, Inc.

Court of Appeals for the Federal Circuit·Decided March 21, 2018·No. 17-1060·Unpublished

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NOTE: This disposition is nonprecedential.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 judgment 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 Consulting 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 various 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. Optum Insight, 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. Optum Insight, 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] method 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 computer system; performing patient analysis using said obtained medical claims data to form episodes of care utilizing the computer system; performing output process based on performed patient analysis utilizing the computer system, the output process comprising:

assigning episodes of care to physicians ; and applying a first maximum duration rule to identify episodes of care;

assigning at least one physician to a report group utilizing the computer system;

4 CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC.

determining eligible physicians and episode of care assignments utilizing the computer system; calculating condition-specific episode of care statistics utilizing the computer system ; calculating weighted episode of care statistics across medical conditions utilizing a predefined set of medical conditions for a specific specialty type utilizing the computer system; and determining efficiency scores for physicians from said calculated condition- specific episode of care statistics and said weighted episode of care statistics calculated 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’ specialties and discloses calculating “weighted episode statistics ” 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 physician ’s marketbasket results to another physician’s marketbasket 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 standardization 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 composition .” 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 episode statistics,” its method “does not use the peer group’s actual episode composition to calculate the weighted average. Instead, the predetermined standard marketbasket 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 marketbasket weights.” Id. col. 93 ll. 31–35.

In 2011, Cave filed suit against Ingenix, Inc., Optum’s predecessor, in the Northern District of California, alleging infringement of the ’126 patent. Optum counterclaimed , 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 services 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 construction hearing. In June 2013, the court issued an order construing, inter alia, certain claim limitations of 6 CAVE CONSULTING GRP., LLC v. OPTUMINSIGHT, INC.

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