Michael Arrigo Admitted as Expert in Colorado Personal Injury Case to Give Testimony Regarding Usual, Customary and Reasonable Charges for Medical Bills

Littleton, CO – A Colorado judge has ruled that testimony from a medical billing and coding expert may proceed in a personal injury case pending in Arapahoe County District Court, a decision that could influence how courts evaluate the reasonableness of medical charges in litigation across the state, according to No World Borders.

On July 24, 2025, District Court Judge Don Jesse Toussaint denied a motion to exclude the testimony of expert witness, Michael Arrigo, an authority on medical billing and healthcare economics, in the matter of Brent Nelson and Kara Merritts v. Benyam Chebud, TIPS, Inc. d/b/a Domino’s Pizza & Domino’s Pizza, LLC (Case No: 2024CV30949). The ruling, which cited the Colorado Rules of Evidence 702 and referenced People v. Shreck, allows Arrigo to provide analysis on the usual, customary and reasonable (UCR) charges for the plaintiff’s medical care based on various standardized coding systems.

Court documents indicate Arrigo’s testimony will address the appropriateness of the plaintiff’s medical bills using methodologies that compare Current Procedural Terminology (CPT) codes, Diagnosis Related Groupings (DRGs), Resource Utilization Groups (RUGs), and Healthcare Common Procedure Coding System (HCPCS) codes. His analysis, as described in pleadings, also includes comparing charges for hospital stays and episodes of care using DRG algorithms, reviewing inpatient and skilled nursing facility (SNF) charges, and examining billing practices without factoring in collateral sources such as insurance payments.

Judge Toussaint’s order specifically noted that Arrigo’s opinion would extend to rebutting the methods used by the opposing party’s expert, particularly concerning the reliability of DRG determinations and the billing practices of SNFs. According to the order, Arrigo’s assessment incorporates a review of patient clinical documentation, physician certifications, and the unique characteristics involved in hospital and SNF billing, including the Minimum Data Set (MDS) used to determine RUG scores for patient care classification.

The court’s decision was reached after considering a motion in limine by the defense to exclude Arrigo’s testimony. The court denied the motion, finding that Arrigo’s qualifications and methodologies satisfied Colorado’s standards for expert witness admissibility. Under CRE 702, courts are charged with ensuring expert testimony is both relevant and the product of reliable principles and methods. In referencing the Colorado Supreme Court decision in People v. Shreck, the court underscored its gatekeeping role, concluding that Arrigo’s testimony met these requirements.

The case, currently proceeding in Arapahoe County, involves allegations concerning the reasonableness of medical expenses incurred following a personal injury incident. The dispute over the admissibility of expert medical billing testimony is notable, as similar issues have arisen in courts nationwide amid ongoing debates about the assessment and substantiation of medical charges in tort litigation.

As the litigation advances, Judge Toussaint’s ruling is expected to serve as a reference point for attorneys and insurers handling cases involving complex medical billing and coding matters. The trial date and subsequent proceedings in Nelson and Merritts v. Chebud et al. will be closely monitored by observers in the legal and healthcare fields.

CASE INFORMATION AND RULING
Motion in Limine to exclude testimony DENIED under CRE 702, the Colorado state standard for determining the admissibility of expert witness testimony, including scientific evidence. (People v. Shreck); ruling of Don Jesse Toussaint, District Court Judge, July 24, 2025. Brent Nelson and Kara Merritts v. Benyam Chebud, TIPS, Inc. d/b/a Dominoes Pizza & Dominoes Pizza, LLC, Case No: 2024CV30949 District Court, Arapahoe County, Colorado.

No World Borders are national experts in healthcare data, regulations and economics. Their team understands the borders between health data and how to unify data quality for actionable views. To find out more about Medicare LCD or to contact an Electronic Health Record and E.H.R. Certification Standards Expert Witness, Expert Witness on Medicare Fraud, Physician Compensation Expert, or HIPAA Privacy Expert Witness contact No World Borders.

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