Many organizations have started filing patent applications directed to such business improvements, such as online insurance claims formatting and filing, for example.
Advancements in technology have provided opportunities for managed care companies to innovate the way they do business. Many organizations have started filing patent applications directed to such business improvements, such as online insurance claim formatting and filing, for example.
Specifically, the Supreme Court's decision in Bilski rejected the so-called machine-or-transformation test, which required a process or method to be tied to a machine or transform an article into a different state or thing in order to qualify as patent-eligible subject matter. It is no longer the sole criterion for determining if a process is patent-eligible. The decision refused to extend the categories of unpatentable subject matter beyond the laws of nature, physical phenomena, and abstract ideas. Such a test, which required machine implementation or physical transformation, echoed requirements of the industrial age.
Some organizations are already ahead of the curve, and patents have been granted on, for example, methods for efficient administration of healthcare plans, detecting fraud by analyzing medical billing patterns, online claim formatting and filing, and health savings account administration. Patent applications have been filed on tools for consumer information, analysis of care regimens, correlating claim information with best practices, evaluating active care management programs, and post-employment healthcare benefits, just to name a few.
As can be seen from these examples, participants in the health insurance industry are already seeking to protect their innovative business models and methods through the U.S. patent system.
PROTECT YOUR MODEL STRATEGY
The recent boost from the U.S. Supreme Court on the eligibility of business methods and information age inventions for patentability should not go unnoticed by managed care. While some participants in the industry have already begun the process of protecting their innovative business methods, the trend has only just begun.
As the information age continues to grow and mature, previously unforeseen inventions and business opportunities will emerge. The managed care and health insurance industry should seek to protect its investment in such inventions through the rights afforded by the U.S. Patent system.
Ned Pejic is a partner in the Intellectual Property Practice and co-chair of the Healthcare and Life Sciences Practice at Calfee, Halter & Griswold LLP.