Shreck Motion

Michael Arrigo medical billing expert witness survives Shreck motion to strike in Colorado
Michael Arrigo, medical billing expert witness, survives Shreck motion to strike in Colorado.  Contact

Shreck Motion Ruling

Michael Arrigo, medical billing expert witness, survives Shreck motion to strike, Case Number: 2021CV30087 (note: for the complete ruling scroll all the way down)

To elaborate, below is the ruling of Jeffrey K. Holmes, District Court Judge.


“THIS MATTER is before the court on various motions filed by the Plaintiffs and Defendant. The Court has considered the filings of the parties as well as applicable law, and finds and orders as follows:

Plaintiff’s Motion to Strike Defendants’ Witness Michael F. Arrigo

Michael Arrigo is a defense medical billing expert. [emphasis added] Plaintiff disagrees with the methodology he used in determining the reasonable and necessary charges for medical care that the Plaintiff received.”

Furthermore, the Court stated that the Plaintiff has the burden of proving her damages by a preponderance of the evidence.

“C.J.I. 6:1. The correct measure of damages is the reasonable and necessary value of the medical services rendered. Kendall v. Hargrave, 142 Colo. 120, 123, 349 P.2d 993, 994 (Colo. 1960). The amount billed to the Plaintiff is clearly some evidence of the reasonable and necessary value of the services provided. Volunteers of America v. Gardenswartz, 242 P.3d 1080, 1087 (Colo. 2010)(quoting Arthur v. Catour, 345 Ill. App.3d 804, 281 Ill. Dec. 243, 803 N.E.2d 647, 649 (2004)(plaintiff’s damages are not limited to the amount paid by her insurer, but may extend to the entire amount billed, provided those charges are reasonable expenses of necessary medical care.”). The defendant, of course, has a right to dispute the amount charged and “the trial setting is the proper forum for the parties to present evidence regarding the proper value of an injured plaintiff’s damages.” Volunteers of America, 242 P.3d at 1087.”

The Court Explains Shreck and Colorado Rule 702

Another key point made by the Court is that “C.R.E. 702 rather than the test in Frye v. United States, 293 F. 1013, 1014 (D.C.Cir. 1923) governs a Colorado trial court’s determination as to whether expert testimony should be admitted at a trial. People v. Shreck, 22 P.3d 68,70 (Colo. 2001). The court’s inquiry focuses on the reliability and relevance of the proffered evidence and requires a determination of the reliability of the scientific principles, the qualifications of the witness, and the usefulness of the testimony to the jury. Id.

Specialized Knowledge Standard for Experts in Medical Billing

Above all, the Court reiterated that “C.R.E. 702 provides that if specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify [emphasis added] thereto in the form of an opinion or otherwise.”

In addition, in the Court’s ruling on the Shreck Motion, it noted that there is nothing novel about medical billing but it is sufficiently complex. Accordingly, the Court elaborated:

“It has not been suggested that there is anything particularly novel about the subject of medical billing or how it can be categorized and calculated. It is sufficiently complex and outside the experience of most lay people, however, that specialized knowledge would be helpful to the jury in determining the proper value of services provided. It is also a subject on which there can obviously be disagreement. Merely because there is disagreement about the proper way to calculate what charges for particular services should be, however, does not mean that one way of doing so should be precluded by court order. “[emphasis added]

“Whether Arrigo qualifies as an expert will need to be determined at trial. Assuming that he does qualify by experience, training, etc. and is permitted to give expert testimony. Plaintiff will be permitted to cross-examine, point out deficiencies in his calculations, and question his conclusions. Plaintiff may, of course, also present contradictory testimony and evidence.   The motion to strike the witness is denied.” [emphasis added]

DONE AND SIGNED this 26th day of September, 2022.

Jeffrey K. Holmes, District Court Judge

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Colorado Shreck motion - expert Michael Arrigo survives motion to strike

Michael F. Arrigo

Michael Arrigo, an expert witness, and healthcare executive, brings four decades of experience in the software, financial services, and healthcare industries. In 2000, Mr. Arrigo founded No World Borders, a healthcare data, regulations, and economics firm with clients in the pharmaceutical, medical device, hospital, surgical center, physician group, diagnostic imaging, genetic testing, health I.T., and health insurance markets. His expertise spans the federal health programs Medicare and Medicaid and private insurance. He advises Medicare Advantage Organizations that provide health insurance under Part C of the Medicare Act. Mr. Arrigo serves as an expert witness regarding medical coding and billing, fraud damages, and electronic health record software for the U.S. Department of Justice. He has valued well over $1 billion in medical billings in personal injury liens, malpractice, and insurance fraud cases. The U.S. Court of Appeals considered Mr. Arrigo's opinion regarding loss amounts, vacating, and remanding sentencing in a fraud case. Mr. Arrigo provides expertise in the Medicare Secondary Payer Act, Medicare LCDs, anti-trust litigation, medical intellectual property and trade secrets, HIPAA privacy, health care electronic claim data Standards, physician compensation, Anti-Kickback Statute, Stark law, the Affordable Care Act, False Claims Act, and the ARRA HITECH Act. Arrigo advises investors on merger and acquisition (M&A) diligence in the healthcare industry on transactions cumulatively valued at over $1 billion. Mr. Arrigo spent over ten years in Silicon Valley software firms in roles from Product Manager to CEO. He was product manager for a leading-edge database technology joint venture that became commercialized as Microsoft SQL Server, Vice President of Marketing for a software company when it grew from under $2 million in revenue to a $50 million acquisition by a company now merged into Cincom Systems, hired by private equity investors to serve as Vice President of Marketing for a secure email software company until its acquisition and multi $million investor exit by a company now merged into Axway Software S.A. (Euronext: AXW.PA), and CEO of one of the first cloud-based billing software companies, licensing its technology to Citrix Systems (NASDAQ: CTXS). Later, before entering the healthcare industry, he joined Fortune 500 company Fidelity National Financial (NYSE: FNF) as a Vice President, overseeing eCommerce solutions for the mortgage banking industry. While serving as a Vice President at Fortune 500 company First American Financial (NYSE: FAF), he oversaw eCommerce and regulatory compliance technology initiatives for the top ten mortgage banks and led the Sarbanes Oxley Act Section 302 internal controls I.T. audit for the company, supporting Section 404 of the Sarbanes Oxley Act. Mr. Arrigo earned his Bachelor of Science in Business Administration from the University of Southern California. Before that, he studied computer science, statistics, and economics at the University of California, Irvine. His post-graduate studies include biomedical ethics at Harvard Medical School, biomedical informatics at Stanford Medical School, blockchain and crypto-economics at the Massachusetts Institute of Technology, and training as a Certified Professional Medical Auditor (CPMA). Mr. Arrigo is qualified to serve as a director due to his experience in healthcare data, regulations, and economics, his leadership roles in software and financial services public companies, and his healthcare M&A diligence and public company regulatory experience. Mr. Arrigo is quoted in The Wall Street Journal, Fortune Magazine, Kaiser Health News, Consumer Affairs, National Public Radio (NPR), NBC News Houston, USA Today / Milwaukee Journal Sentinel, Medical Economics, Capitol ForumThe Daily Beast, the Lund Report, Inside Higher Ed, New England Psychologist, and other press and media outlets. He authored a peer-reviewed article regarding clinical documentation quality to support accurate medical coding, billing, and good patient care, published by Healthcare Financial Management Association (HFMA) and published in Healthcare I.T. News. Mr. Arrigo serves as a member of the board of directors of a publicly traded company in the healthcare and data analytics industry, where his duties include: member, audit committee; chair, compensation committee; member, special committee.

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