TIMOTHY J. CORRIGAN, District Judge.
This personal injury case came before the Court for a final pretrial conference and hearing on pending motions on February 20, 2020, the record of which is incorporated by reference. The Court ruled on most of the motions from the bench and those rulings are recounted below.
Under the familiar
Reimer, who is certified in professional medical coding and billing and is a member of the American Academy of Professional Coders, has analyzed plaintiff's medical bills related to this case. Defendant seeks to admit his testimony to demonstrate that the medical procedures were not correctly billed, and that the bills far exceed the usual, customary and reasonable charges for the services rendered. Reimer will not testify as to the need for or reasonableness of plaintiff's treatment.
In her motion, plaintiff does not raise any real challenge to Reimer's qualifications to review, understand, and analyze medical bills and indeed, his CV reveals he has significant education, training and experience in the field of medical billing and coding. Nor does plaintiff seriously challenge Reimer's methodology as it relates to his analysis of whether procedures were properly billed (such as the unbundling of services or upcoding), testimony the Court finds would be helpful to the jury in assessing the reasonableness of Larrieux's medical expenses, and which it will allow.
Instead, the crux of plaintiff's challenge is to the methodology and helpfulness of Reimer's opinions that Larrieux's medical bills exceed the usual, customary and reasonable charges for the services rendered. To calculate the reasonable charges for various services, Reimer relies on benchmarks from the "resource-based relative value scale," which, according to Reimer, is a recognized "physician payment system used and endorsed by the American Medical Association, the U.S. Department of Health and Human Services, and most other medical providers." Doc. 31, Ex. D at ¶¶ 23-24. Although plaintiff argues this scale is not applicable to self-pay or uninsured patients, she offers no evidence of that and Reimer, who plaintiff did not depose, states to the contrary in his report.
The question of the helpfulness of Reimer's testimony on this issue is a closer call. While some courts have excluded medical billing code expert testimony on the grounds that it will not help the jury to determine a fact in issue, or that it will cause undue confusion, other courts have found it to be probative of the reasonableness of plaintiff's medical expenses.
Without knowing what evidence will come in during the plaintiff's case-in-chief, the Court is unwilling to say that Reimer's opinions as to the reasonableness of plaintiff's medical expenses will be unhelpful or will cause confusion or prejudice. As defendant points out, it cannot be that whatever plaintiff's medical providers charge is
Accordingly, it is hereby
1. Plaintiff's Motion to Exclude or Limit the Testimony of Defendant's Billing Code Expert Jeremy Reimer (Doc. 21) is
2. Defendant's Motion to Exclude any Expert Testimony, Including But Not Limited to, From Plaintiff's Treating Physicians and Healthcare Providers (Doc. 19) is
3. Plaintiff's Motion to Exclude the Testimonies of Donald J. Fournier, Jr., P.E., and Steven Mitchell, P.E. (Doc. 22) is
4. Plaintiff's Motion to Exclude or Limit the Testimony of Ying Lu, Ph.D. (Doc. 23) is
5. Defendant's Motion to Bifurcate Trial on the Issues of Liability and Damages (Doc. 42) is
6. No later than
Although not argued at the hearing, defendant also moved to exclude any testimony from the treaters on engineering or biomechanical issues on the grounds that such testimony is outside their area of expertise. The Court agrees with that general principle, but would permit the treaters to testify consistent with their treatment notes, which testimony is subject to cross-examination.
Plaintiff represented at the hearing that she no longer intends to call Dr. Chris Tomaselli to testify so the motion as to his testimony is moot.
Additionally, as discussed on the record, the relevance (and, therefore, the admissibility) of Mitchell's opinion regarding whether a crank could have hit Larrieux's vehicle is contingent on the testimony of Larrieux.