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Central Valley Ag Cooperative v. Leonard

United States District Court, D. Nebraska

May 15, 2019

CENTRAL VALLEY AG COOPERATIVE, for itself and as Fiduciary of the Central Valley Ag Cooperative Health Care Plan; Plaintiff,
v.
DANIEL K. LEONARD, SUSAN LEONARD, THE BENEFIT GROUP, INC., ANASAZI MEDICAL PAYMENT SOLUTIONS, INC., CLAIMS DELEGATE SERVICES, LLC, and GMS BENEFITS, INC., Defendants.

          ORDER

          Cheryl R. Zwart United States Magistrate Judge

         Plaintiff's motion to supplement the opinions of its expert, Rachel Harris, (Filing No. 219), is now pending before me and fully submitted. For the reasons stated below, the motion will be denied.

         FACTUAL BACKGROUND

         This lawsuit was filed on October 11, 2017. (Filing No. 1). The undersigned magistrate judge has previously and extensively outlined the significant progression and discovery hurdles encountered in preparing this case for trial. (Filing No. 151). That history is supplemented but not repeated herein.

         The court's order entered on January 12, 2019 extended the expert disclosure deadlines as follows:

The deadlines for complete expert disclosures for all experts expected to testify at trial, (both retained experts, (Fed. R. Civ. P. 26(a)(2)(B)), and non-retained experts, (Fed. R. Civ. P. 26(a)(2)(C)), are:
For the plaintiff: January 29, 2019.
For the defendants: March 29, 2019.
Any rebuttal: April 12, 2019.

(Filing No. 151).

         Plaintiff timely produced the report of its expert, Rachel Harris, on January 29, 2019. (Filing No. 219-1, at CM/ECF p. 1; Filing No. 245-1). Ms. Harris summarized her opinions as follows:

As a result of my study, understanding and use of the aforementioned facts, assumptions and data provided to me by counsel for Plaintiff, and as summarized herein, I conclude the following:
• It is my expert opinion that TBG and AMPS routinely reprocessed CY 2015 and CY 2016 claims for no discernible reason other than their administrative errors. Further, that insufficient methodologies and internal controls were in place by either TBG or AMPS to prevent and correct such errors resulting in overstated gross charges over $4.SM across CY 2015 and CY 2016, as drove program and claims administration fees.
• It is my expert opinion that insufficient methodologies and internal controls were in place to accurately determine provider and service type eligibility under the services agreement definitions of hospital and facility claims, resulting in approximately $395K and $1.2M in AMPS overpayments for CY 2015 and CY 2016, respectively.
• It is my expert opinion that insufficient methodologies and internal controls were in place to accurately determine MBR program eligibility and related AMPS fees, resulting in excess fees paid by CVA in CY 2015 of approximately $86K.
• It is my expert opinion that insufficient methodologies and internal controls were in place to accurately determine RBR program fees, resulting in excess fees ...

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