Free Declaration - District Court of Delaware - Delaware

l I Case 1 :04-cv-01258-SLR Document 155 Filed 12/15/2005 Page 1 of 4
I
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
MCKES SON INFORMATION SOLUTIONS
LLC,
Plaintiff,
v. Civil Action No. 04-1258-SLR ‘
THE TRIZETTO GROUP, INC. To
Defendant.
DECLARATION OF CRAIG P. LUFTIG
IN SUPPORT OF THE TRIZETTO GROUP, IN C.'S
MOTION FOR SUMMARY JUDGMENT OF NON-INFRINGEMENT

" Case 1 :04-cv-01258-SLR Document 155 Filed 12/15/2005 Page 2 of 4
I, Craig Luftig, declare as follows:
l. I am employed by The TriZetto Group, Inc. ("TriZetto”) as Senior Director of
Product Development and Management for TriZetto’s Facets product. I submit this declaration
in support of TriZetto's motion for summary judgment of non-iniiingement. I have personal
knowledge of the facts set forth herein and if called upon to do so, I could and would testify
competently hereto.
2. Facets is a software product used by insurers, health maintenance organizations
(HMOs), preferred provider organizations (PPOs), and other health benefit providers to process
claims for medical services. Facets can perform a wide range of claims processing functions,
including clinical editing.
3. Clinical editing involves checking and editing the medical procedure codes on a
medical claim in accordance with expert-derived clinical criteria. The clinical criteria constitute
associations between specific medical procedure codes, indicating whether particular codes are
appropriate when submitted in combination with other codes, either on the same medical claim
or separate claims for the same patient. The clinical criteria can incorporate several types of
multiple-code edits that define the association between the codes. For example, the Subset
Procedure Edit indicates that one code is a subset of a second code and should not be billed
together with the second code.
4. The clinical criteria in Facets are contained in the Facets Clinical Editing
database. Each clinical criterion is listed as a separate row in a table of that database.
5. Facets provides an interface that the customer can use to modify clinical criteria
in the database as desired. The customer can activate or deactivate particular clinical criteria,
delete existing clinical criteria, add new clinical criteria, or change the tenns of particular clinical
criteria. The customer can also control what level of editing they wish to use by choosing which
edits to apply.
6. Facets does not check to see if a received claim has more than one code in order
to perform clinical editing. Facets will perform clinical editing (including multiple-code edits, if
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, Case 1 :04-cv-01258-SLR Document 155 Filed 12/15/2005 Page 3 of 4

applicable) on all claims received, regardless of the number of codes present on the claim. In the
process of clinical editing, Facets will examine any codes submitted on earlier claims for the
same patient together with the code or codes from the current claim.
I declare tmder penalty of perjury under the laws of the United States of America that the
foregoing is true and correct.
This declaration was executed this 14th day of December, 2005, at Union, New Jersey.
- Q ir
Cra r P. Luftig
wsC.tmp
3

Case 1:04-cv-01258-SLR Document 155 Filed 12/15/2005 Page 4 of 4
CERTIFICATE OF SERVICE
I, Jack B. Blumenfeld, hereby certify that on December 15, 2005 I electronically
filed Declaration of Craig P. Luitig in Support of the TriZetto Group, Inc.’s Motion for Stunmary
Judgment of Non-Infringement with the Clerk of the Court using CM/ECF, which will send
notification of such filing(s) to the following:
Thomas J. Allingham, II
Skadden, Arps, Slate, Meagher & Flom LLP
I also certify that copies were caused to be served on December 15, 2005 upon the
following in the manner indicated:
BY HAND ,
Thomas J. Allingham, II
Skadden, Arps, Slate, Meagher & Flom LLP
One Rodney Square
P.O. Box 636
Wilmington, DE 19899
BY EMAIL
Jeffrey G. Randall
Skadden, Arps, Slate, Meagher & Flom LLP
525 University Avenue
Suite 1100 V
Palo Alto, CA 94301]
/s/ Jack B. Blumenfeld 1#lO14)
Morris, Nichols, Arsht & Tunnell
1201 N. Market Street
P.O. Box 1347
Wilmington, DE 19899
(302) 658-9200
[email protected]