Athena Diagnostics, Inc. v. Mayo Collaborative Services , 927 F.3d 1333 ( 2019 )


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  •   United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    ON PETITION FOR REHEARING EN BANC
    ______________________
    ADAM GAHTAN, Fenwick & West, New York, NY, filed a
    petition for rehearing en banc for plaintiffs-appellants.
    Also represented by ERIC M. MAJCHRZAK, VANESSA PARK-
    THOMPSON; ANDREW JOSEPH KABAT, EMMETT J. MCMAHON,
    Robins Kaplan LLP, Minneapolis, MN; DIMITRIOS T.
    DRIVAS, White & Case LLP, New York, NY.
    JONATHAN ELLIOT SINGER, Fish & Richardson, PC, San
    2          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    Diego, CA, filed a response to the petition for defendants-
    appellees. Also represented by JOHN CAMERON ADKISSON,
    ELIZABETH M. FLANAGAN, PHILLIP GOTER, DEANNA JEAN
    REICHEL, Minneapolis, MN.
    MELISSA A. BRAND, Biotechnology Innovation Organi-
    zation, Washington, DC, for amici curiae Biotechnology In-
    novation     Organization,    CropLife      International,
    Pharmaceutical Research and Manufacturers of America,
    Wisconsin Alumni Research Foundation. Also represented
    by HANSJORG SAUER. Amicus curiae Biotechnology Inno-
    vation Organization also represented by BRIAN PAUL
    BARRETT, Eli Lilly and Company, Indianapolis, IN. Amicus
    curiae Pharmaceutical Research and Manufacturers of
    America also represented by DAVID EVAN KORN, Pharma-
    ceutical Research and Manufacturers Association of Amer-
    ica, Washington, DC.
    MATTHEW JAMES DOWD, Dowd Scheffel PLLC, Wash-
    ington, DC, for amici curiae Richard A. Epstein, Christo-
    pher Michael Holman, Adam Mossoff, Kristen J. Osenga,
    Michael Risch, Ted M. Sichelman, Brenda M. Simon. Also
    represented by ROBERT JAMES SCHEFFEL.
    SHERRY M. KNOWLES, Knowles Intellectual Property
    Strategies, LLC, Atlanta, GA, for amici curiae Freenome
    Holdings Inc., Achillion Pharmaceuticals, Inc. Also repre-
    sented by MEREDITH MARTIN ADDY, AddyHart P.C., At-
    lanta, GA.
    ______________________
    Before PROST, Chief Judge, NEWMAN, LOURIE, DYK, MOORE,
    O’MALLEY, REYNA, WALLACH, TARANTO, CHEN, HUGHES,
    and STOLL, Circuit Judges.
    LOURIE, Circuit Judge, with whom REYNA and CHEN,
    Circuit Judges, join, concurs in the denial of the petition
    for rehearing en banc.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE                3
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    HUGHES, Circuit Judge, with whom PROST, Chief
    Judge, and TARANTO, Circuit Judge, join, concurs in the
    denial of the petition for rehearing en banc.
    DYK, Circuit Judge, with whom HUGHES, Circuit
    Judge, joins, and with whom CHEN, Circuit Judge, joins as
    to Parts IV, V, and VI, concurs in the denial of the peti-
    tion for rehearing en banc.
    CHEN, Circuit Judge, concurs in the denial of the peti-
    tion for rehearing en banc.
    MOORE, Circuit Judge, with whom O’MALLEY,
    WALLACH, and STOLL, Circuit Judges, join, dissents from
    the denial of the petition for rehearing en banc.
    NEWMAN, Circuit Judge, with whom WALLACH, Cir-
    cuit Judge, joins, dissents from the denial of the petition
    for rehearing en banc.
    STOLL, Circuit Judge, with whom WALLACH, Circuit
    Judge, joins, dissents from the denial of the petition for
    rehearing en banc.
    O’MALLEY, Circuit Judge, dissents from the denial of the
    petition for rehearing en banc.
    PER CURIAM.
    ORDER
    A petition for rehearing en banc was filed by appellants
    Athena Diagnostics, Inc., Oxford University Innovation
    Ltd., and the Max-Planck-Gesellschaft zur Forderung der
    Wissenschaften E.V. A response to the petition was invited
    by the court and filed by appellees Mayo Collaborative Ser-
    vices, LLC and Mayo Clinic. Several motions for leave to
    file amici curiae briefs were filed and granted by the court.
    The petition for rehearing, response, and amici curiae
    briefs were first referred to the panel that heard the ap-
    peal, and thereafter, to the circuit judges who are in regu-
    lar active service. A poll was requested, taken, and failed.
    4           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Upon consideration thereof,
    IT IS ORDERED THAT:
    1) The petition for panel rehearing is denied.
    2) The petition for rehearing en banc is denied.
    3) The mandate of the court will issue on July 10,
    2019.
    FOR THE COURT
    July 3, 2019                /s/ Peter R. Marksteiner
    Date                     Peter R. Marksteiner
    Clerk of Court
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    LOURIE, Circuit Judge, with whom REYNA and CHEN, Cir-
    cuit Judges, join, concurring in the denial of the petition
    for rehearing en banc.
    I concur in the court’s decision not to rehear this case
    en banc. In my view, we can accomplish little in doing so,
    as we are bound by the Supreme Court’s decision in Mayo.
    Some of us have already expressed our concerns over cur-
    rent precedent. E.g., Athena Diagnostics, Inc. v. Mayo Col-
    laborative Servs., LLC, 
    915 F.3d 743
    , 753 n.4 (Fed. Cir.
    2019); Ariosa Diagnostics, Inc. v. Sequenom, Inc., 
    809 F.3d 1282
    , 1284 (Fed. Cir. 2015) (Lourie, J., concurring in the
    2          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    denial of rehearing en banc); 
    id. at 1287
    (Dyk, J., concur-
    ring in the denial of rehearing en banc).
    If I could write on a clean slate, I would write as an
    exception to patent eligibility, as respects natural laws,
    only claims directed to the natural law itself, e.g., E=mc2,
    F=ma, Boyle’s Law, Maxwell’s Equations, etc. I would not
    exclude uses or detection of natural laws. The laws of an-
    ticipation, obviousness, indefiniteness, and written de-
    scription provide other filters to determine what is
    patentable.
    But we do not write here on a clean slate; we are bound
    by Supreme Court precedent. In Mayo Collaborative Ser-
    vices v. Prometheus Laboratories, Inc., the claims at issue
    were held by the Court to be directed to the relationship
    between the concentration of metabolites in the blood and
    the likelihood that a drug dose will be ineffective, which it
    referred to as a law of nature. 
    566 U.S. 66
    , 74–75, 77
    (2012). The other steps—administering a drug and detect-
    ing the level of a specific metabolite—added only “[p]urely
    ‘conventional or obvious’ ‘[pre]-solution activity’” that was
    “not sufficient to transform an unpatentable law of nature
    into a patent-eligible application of such a law.” 
    Id. at 79
    (second alteration in original) (quoting Parker v. Flook, 
    437 U.S. 584
    , 590 (1978)); see Bilski v. Kappos, 
    561 U.S. 593
    ,
    610–11 (2010) (“[T]he prohibition against patenting ab-
    stract ideas ‘cannot be circumvented by attempting to limit
    the use of the formula to a particular technological envi-
    ronment’ or adding ‘insignificant postsolution activity.’”
    (quoting Diamond v. Diehr, 
    450 U.S. 175
    , 191–92 (1981)));
    
    Flook, 437 U.S. at 590
    (“The notion that post-solution ac-
    tivity, no matter how conventional or obvious in itself, can
    transform an unpatentable principle into a patentable pro-
    cess exalts form over substance.”). Because the claims re-
    cited only what the Court called a natural law together
    with well-understood, conventional activity, the Court con-
    cluded the claims were ineligible under § 101. 
    Mayo, 566 U.S. at 73
    , 79–80.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               3
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    In applying Mayo, we have accordingly held claims fo-
    cused on detecting new and useful natural laws with con-
    ventional steps to be ineligible. E.g., Cleveland Clinic
    Found. v. True Health Diagnostics LLC, 
    859 F.3d 1352
    ,
    1363 (Fed. Cir. 2017), cert. denied, 
    138 S. Ct. 2621
    (2018);
    Ariosa Diagnostics, Inc. v. Sequenom, Inc., 
    788 F.3d 1371
    ,
    1378 (Fed. Cir. 2015), cert. denied, 
    136 S. Ct. 2511
    (2016).
    In Cleveland Clinic, the claims recited a specific assay to
    detect the protein MPO, the enzyme-linked immuno-
    sorbent 
    assay. 859 F.3d at 1357
    –58, 1362. Ariosa similarly
    involved a specific technique to amplify and detect DNA,
    the polymerase chain 
    reaction. 788 F.3d at 1377
    . But in
    both cases, the patents’ specifications described these tech-
    niques as well-understood and conventional. Cleveland
    
    Clinic, 859 F.3d at 1355
    ; 
    Ariosa, 788 F.3d at 1377
    . We con-
    cluded that using these routine assays to detect new natu-
    ral phenomena did not transform the claims into patent
    eligible applications. Cleveland 
    Clinic, 859 F.3d at 1362
    –
    63; 
    Ariosa, 788 F.3d at 1376
    –77.
    In contrast, new method of treatment patents do not
    fall prey to Mayo’s prohibition. E.g., Vanda Pharm. Inc. v.
    West-Ward Pharm. Int’l Ltd., 
    887 F.3d 1117
    , 1136 (Fed.
    Cir. 2018). Nor have unconventional arrangements of
    known laboratory techniques, even if directed to a natural
    law. Rapid Litig. Mgmt. Ltd. v. CellzDirect, Inc., 
    827 F.3d 1042
    , 1051 (Fed. Cir. 2016). But this case involves neither
    scenario. Athena’s claims recite observing a natural law
    using a radioimmunoassay that the specification describes
    as “standard” and “known per se in the art.” U.S. Patent
    7,267,820 col. 3 ll. 33–37, col. 4 ll. 10–12. The claims do not
    recite a new method of treatment or an unconventional
    combination of steps to detect the natural law. The only
    unconventional aspect is the inventors’ discovery of what
    the Supreme Court would call the natural law—the corre-
    lation between MuSK autoantibodies and the neurological
    disorder myasthenia gravis—but we cannot premise eligi-
    bility solely on the natural law’s novelty. Mayo, 
    566 U.S. 4
             ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    at 73 (concluding that “the steps in the claimed processes
    (apart from the natural laws themselves) involve well-un-
    derstood, routine, conventional activity previously engaged
    in by researchers in the field” (emphasis added)); 
    Flook, 437 U.S. at 591
    –92 (“[T]he novelty of the mathematical al-
    gorithm is not a determining factor at all” and “is treated
    as though it were a familiar part of the prior art.”). Under
    Supreme Court precedent, I do not believe that specific yet
    purely conventional detection steps impart eligibility to a
    claim that otherwise only sets forth what the Court has
    held is a natural law. That is the situation presented in
    Ariosa, Cleveland Clinic, and now Athena. Accordingly, as
    long as the Court’s precedent stands, the only possible so-
    lution lies in the pens of claim drafters or legislators. We
    are neither.
    Amici and others have complained that our eligibility
    precedent is confused. However, our cases are consistent.
    They have distinguished between new method of treatment
    claims and unconventional laboratory techniques, on the
    one hand, and, on the other hand, diagnostic methods that
    consist of routine steps to observe the operation of a natu-
    ral law, a clear line. Beyond that, I do not see a way clear
    to distinguish Mayo in a useful, principled, fashion. Soft-
    ware is another matter, but such patents are not before us
    here.
    I therefore concur in the decision of the court not to
    take this case en banc because I do not believe we can con-
    vincingly distinguish Mayo in this case.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    HUGHES, Circuit Judge, with whom PROST, Chief Judge,
    and TARANTO, Circuit Judge, join, concurring in the denial
    of the petition for rehearing en banc.
    The multiple concurring and dissenting opinions re-
    garding the denial of en banc rehearing in this case are il-
    lustrative of how fraught the issue of § 101 eligibility,
    especially as applied to medical diagnostics patents, is. I
    agree that the language in Mayo, as later reinforced in Al-
    ice, forecloses this court from adopting an approach or
    reaching a result different from the panel majority’s. I also
    2           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    agree, however, that the bottom line for diagnostics patents
    is problematic. But this is not a problem that we can solve.
    As an inferior appellate court, we are bound by the Su-
    preme Court.
    I, for one, would welcome further explication of eligibil-
    ity standards in the area of diagnostics patents. Such
    standards could permit patenting of essential life saving
    inventions based on natural laws while providing a reason-
    able and measured way to differentiate between overly
    broad patents claiming natural laws and truly worthy spe-
    cific applications. Such an explication might come from the
    Supreme Court. Or it might come from Congress, with its
    distinctive role in making the factual and policy determi-
    nations relevant to setting the proper balance of innovation
    incentives under patent law.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    DYK, Circuit Judge, with whom HUGHES, Circuit Judge,
    joins, and with whom CHEN, Circuit Judge, joins as to Parts
    IV, V, and VI, concurring in the denial of the petition for
    rehearing en banc.
    I
    In the realm of abstract ideas, the Mayo/Alice frame-
    work has successfully screened out claims that few would
    contend should be patent eligible, for example, those that
    merely apply well-known business methods and other
    2          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    processes using computers or the Internet. 1 The Mayo/Al-
    ice framework has thus proven to be both valuable and ef-
    fective at invalidating overly broad, non-inventive claims
    that would effectively “grant a monopoly over an abstract
    idea.” Alice Corp. v. CLS Bank Int’l, 
    573 U.S. 208
    , 216
    (2014) (quoting Bilski v. Kappos, 
    561 U.S. 593
    , 611–612
    (2010)). As the Supreme Court has recognized, the concern
    with such patents is that they would “‘inhibit further
    1   See, e.g., Trading Techs. Int’l, Inc. v. IBG LLC, 
    921 F.3d 1378
    , 1384–85 (Fed. Cir. 2019) (invalidating claims
    directed to “providing a trader with additional financial in-
    formation to facilitate market trades” using “a generic com-
    puter”); SAP Am., Inc., v. Investpic, LLC, 
    898 F.3d 1161
    ,
    1167–69 (Fed. Cir. 2018) (invalidating claims directed to
    “the selection and mathematical analysis of [investment]
    information, followed by reporting or display of the results”
    using “off-the-shelf computer technology”); Credit Ac-
    ceptance Corp. v. Westlake Servs., 
    859 F.3d 1044
    , 1054–57
    (Fed. Cir. 2017) (invalidating claims directed to “processing
    an application for financing a purchase” using “generic
    computer components”); Elec. Power Grp., LLC v. Alstom
    S.A., 
    830 F.3d 1350
    , 1353–55 (Fed. Cir. 2016) (invalidating
    claims directed to “collecting information, analyzing it, and
    displaying certain results” using “off-the-shelf, conven-
    tional computer, network, and display technology”); Intel-
    lectual Ventures I LLC v. Capital One Bank, 
    792 F.3d 1363
    ,
    1369–70 (Fed. Cir. 2015) (invalidating claims directed to
    tailoring advertising to individual customers using a “ge-
    neric web server with attendant software”); Ultramercial,
    Inc. v. Hulu, LLC, 
    772 F.3d 709
    , 715–16 (Fed. Cir. 2014)
    (invalidating a claim directed to “using advertising as an
    exchange or currency” “on the Internet”); buySAFE, Inc. v.
    Google, Inc., 
    765 F.3d 1350
    , 1355 (Fed. Cir. 2014) (invali-
    dating a claim directed to “creating a contractual relation-
    ship” through “online transactions” using “generic”
    computer functionality).
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               3
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    discovery by improperly tying up the future use of’ these
    buildings blocks of human ingenuity.” 
    Id. (quoting Mayo
    Collaborative Servs. v. Prometheus Labs., Inc., 
    566 U.S. 66
    ,
    85 (2012)). At the same time, our § 101 precedent has al-
    lowed room for claims that do more than recite conven-
    tional applications of abstract concepts. 2
    II
    Despite assertions to the contrary, the doctrines of nov-
    elty under § 102, obviousness under § 103, and enablement
    and written description under § 112 cannot adequately
    guard against the dangers of overclaiming. In Mayo, the
    Supreme Court rejected the argument that “other statu-
    tory provisions”—specifically §§ 102, 103, and 112—could
    adequately “perform th[e] screening function” served by
    § 
    101. 566 U.S. at 89
    . Although the Court recognized that
    the § 101 patent eligibility inquiry “might sometimes over-
    lap” with considerations of novelty and non-obviousness
    under §§ 102 and 103, it concluded that “to shift the patent-
    eligibility inquiry entirely to these later sections risks cre-
    ating significantly greater legal uncertainty, while assum-
    ing that those sections can do work that they are not
    equipped to do.” 
    Id. at 90.
    Those sections and § 112 do not
    adequately address “the risk that a patent on the [natural]
    2   See, e.g., Ancora Techs., Inc. v. HTC Am., Inc., 
    908 F.3d 1343
    , 1348–49 (Fed. Cir. 2018) (holding that claim to
    a specific technique for improving computer security
    against unauthorized use of a program was not directed to
    an abstract idea); Finjan, Inc. v. Blue Coat Sys., Inc., 
    879 F.3d 1299
    , 1303–04 (Fed. Cir. 2018) (holding that claims to
    a “behavior-based virus scan” allowing for more flexible
    and nuanced virus filtering were not directed to an abstract
    idea); Enfish, LLC v. Microsoft Corp., 
    822 F.3d 1327
    , 1336–
    38 (Fed. Cir. 2016) (holding that claims to self-referential
    tables that allowed for more efficient launching and adap-
    tation of databases were not directed to an abstract idea).
    4           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    law would significantly impede future innovation.” 
    Id. at 90–91;
    see also Mark Lemley et al., Life After Bilski, 63
    Stan. L. Rev. 1315, 1329–32 (2011) (outlining differences
    between §§ 101 and 112). Nor do these other provisions
    typically allow early stage resolution of the “threshold” is-
    sue of patent eligibility, 
    Bilski, 561 U.S. at 602
    , necessary
    to avoid the costs of lengthy litigation. Thus, § 101 serves
    an important purpose not served by these other provisions
    in the Patent Act.
    A simple example in the area of diagnostic patents il-
    lustrates this point. If the first person to identify the rela-
    tionship between a genetic abnormality and a disease had
    sought a broad patent on a method of searching for genetic
    abnormalities and determining their relationship to dis-
    ease, the claims would have been neither anticipated nor
    obvious. Nor is it likely that they would they have been
    invalid for lack of enablement (since a representative spe-
    cies was disclosed) or written description (the overall con-
    ception being in the mind of the inventor). The only barrier
    to such broad patent claiming is § 101.
    In fact, one of the diagnostic patents that we have held
    unpatentable under § 101 had exactly that problem of over-
    breadth. In In re BRCA1- & BRCA2-Based Hereditary
    Cancer Test Patent Litigation, 
    774 F.3d 755
    (Fed. Cir.
    2014), we held that genetic testing claims were directed to
    the “patent-ineligible abstract idea of comparing BRCA se-
    quences and determining the existence of alterations” of
    the gene. 
    Id. at 763.
    We noted the breadth of the claims,
    explaining that they “are not restricted by the purpose of
    the comparison or the alteration being detected,” nor “lim-
    ited to the detection of risk of breast or ovarian cancer.” 
    Id. at 763–64.
    Indeed, the claims encompassed “comparisons
    for purposes other than detection of cancer.” Id.; see also
    Ariosa Diagnostics, Inc. v. Sequenom, Inc., 
    788 F.3d 1371
    ,
    1373–74, 1378 (Fed. Cir. 2015) (invalidating claims to
    methods of detecting cffDNA in maternal serum or plasma
    that encompassed any diagnosis of any disease). What was
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              5
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    claimed was a broad concept, and we therefore held the
    claims ineligible under § 101, though the claims may well
    have survived challenge under §§ 102, 103, and 112.
    III
    The problem with § 101 arises not in implementing the
    abstract idea approach of Alice, but rather in implementing
    the natural law approach of Mayo. Although Mayo’s frame-
    work is sound overall, I share the concerns expressed by
    my dissenting colleagues that the Mayo test for patent eli-
    gibility should leave room for sufficiently specific diagnos-
    tic patents. But it is the Supreme Court, not this court,
    that must reconsider the breadth of Mayo.
    Although the Supreme Court’s decision in Mayo did not
    make all diagnostic claims patent ineligible, as we previ-
    ously held in 
    Ariosa, 788 F.3d at 1376
    –77, Mayo left no
    room for us to find typical diagnostic claims patent eligible,
    absent some inventive concept at Mayo step two. The panel
    here correctly concluded that Mayo controls.
    The inventors of U.S. Patent 7,267,820 (“the ’820 pa-
    tent”) discovered that myasthenia gravis (“MG”), a neuro-
    logical disorder, can be diagnosed by detecting the presence
    of MuSK autoantibodies in bodily fluid. See Athena Diag-
    nostics, Inc. v. Mayo Collaborative Servs., LLC, 
    915 F.3d 743
    , 747 (Fed. Cir. 2019). At Mayo step one, the claims are
    directed to a natural law: “the correlation between the
    presence of naturally-occurring MuSK autoantibodies in
    bodily fluid” and certain neurological diseases like MG. 
    Id. at 750.
    This is similar to the correlation between “concen-
    trations of certain metabolites in the blood and the likeli-
    hood that a dosage of a thiopurine drug will prove
    ineffective or cause harm,” which the Supreme Court held
    “sets forth a natural law” in 
    Mayo, 566 U.S. at 77
    .
    So too as in Mayo, at step two, the additional steps of
    the claims here, though “set forth with some specificity,”
    
    Athena, 915 F.3d at 752
    , “only require standard techniques
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    to be applied in a standard way” and thus do not supply the
    requisite inventive concept, 
    id. at 753.
    The specification
    explains that “[t]he actual steps of detecting autoantibod-
    ies in a sample of bodily fluids may be performed in accord-
    ance with immunological assay techniques known per se in
    the art.” 
    Id. at 753–54
    (alteration in original). Similarly,
    in Mayo, adding steps “to determine the level of the rele-
    vant metabolites in the blood” was held “not sufficient to
    transform an unpatentable law of nature into a patent-eli-
    gible application” because those steps were “well known in
    the 
    art.” 566 U.S. at 79
    . Therefore, the panel here correctly
    held that under the Mayo framework, the claims are not
    patent eligible under § 101. 
    Athena, 915 F.3d at 746
    , 756.
    And the Supreme Court has instructed us to follow its prec-
    edent until the Court itself chooses to expressly overrule
    it. 3
    IV
    It is nonetheless appropriate to point out that there is
    tension between Mayo and the Supreme Court’s later deci-
    sion in Association for Molecular Pathology v. Myriad
    3    See, e.g., Hohn v. United States, 
    524 U.S. 236
    , 252–
    53 (1998) (“Our decisions remain binding precedent until
    we see fit to reconsider them, regardless of whether subse-
    quent cases have raised doubts about their continuing vi-
    tality.”); State Oil Co. v. Khan, 
    522 U.S. 3
    , 20 (1997) (“The
    Court of Appeals was correct in applying that principle de-
    spite disagreement with [the precedent], for it is this
    Court’s prerogative alone to overrule one of its prece-
    dents.”); Rodriguez de Quijas v. Shearson/Am. Express,
    Inc., 
    490 U.S. 477
    , 484 (1989) (“If a precedent of this Court
    has direct application in a case, yet appears to rest on rea-
    sons rejected in some other line of decisions, the Court of
    Appeals should follow the case which directly controls,
    leaving to this Court the prerogative of overruling its own
    decisions.”).
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            7
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    Genetics, Inc., 
    569 U.S. 576
    (2013), and that the holding of
    Mayo may be overbroad. The language of § 101 does cover
    “discover[ies],” 35 U.S.C. § 101, and there is no doubt that
    determining the relationship between specific genetic ab-
    normalities and specific diseases constitutes an important
    discovery with proven utility. There is much to be said for
    the patentability of claims to such discoveries, if not
    drafted overbroadly. And Myriad suggests that such dis-
    coveries may be patent eligible. There, the patent appli-
    cant discovered a previously unknown natural
    phenomenon: the location and sequence of the BRCA1 and
    BRCA2 genes and their connection to cancer. 
    Myriad, 569 U.S. at 582
    –83. Although the Court held ineligible the
    claims to naturally occurring DNA sequences, it suggested
    that “new applications of knowledge about the BRCA1 and
    BRCA2 genes” could be eligible and referred to various “un-
    challenged claims” discussed in Judge Bryson’s concur-
    rence to our court’s decision below. 
    Id. at 596
    (emphasis in
    original) (citing Ass’n for Molecular Pathology v. U.S. Pa-
    tent & Trademark Office, Inc., 
    689 F.3d 1303
    , 1349 (Fed.
    Cir. 2012) (Bryson, J. concurring)). One of these “unchal-
    lenged claims” was claim 21 of Myriad’s U.S. Patent No.
    5,753,441, which covered a method of detecting (using con-
    ventional methods) any of several specific mutations in the
    BRCA1 gene, newly discovered by the patent applicant and
    shown to increase a person’s risk of developing particular
    cancers (a far narrower claim than the claims held un-
    patentable in BRCA1- & BRCA2).
    By suggesting that such a claim could be patent eligi-
    ble, Myriad thus recognized that an inventive concept can
    sometimes come from the discovery of an unknown natural
    phenomenon and its application for a diagnostic purpose.
    This appears to be in tension with Mayo. Under Mayo, a
    natural phenomenon itself, no matter how narrow and spe-
    cific, cannot supply the requisite “inventive concept.” See
    
    Mayo, 566 U.S. at 77
    –78, 88–89.
    8           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Thus, it would be desirable for the Supreme Court to
    refine the Mayo framework to allow for sufficiently specific
    diagnostic patent claims with proven utility. In the life sci-
    ences, development of new diagnostic methods is often
    based on researching complex biological systems. The in-
    ventive concepts in this area may lie primarily in the ap-
    plication of a natural law.
    V
    At the same time, Mayo’s central concern was both im-
    portant and consistent with the Patent Act. There is a sub-
    stantial risk that overbroad claims involving natural laws
    may “preempt the use of a natural law” and thus “inhibit
    further discovery by improperly tying up the future use of
    laws of nature.” 
    Id. at 72,
    85. In other words, there is a
    risk that granting overbroad patents could reward a mere
    concept rather than the work subsequently done by the ac-
    tual inventor. The risks associated with such overbreadth
    are shown by the examples discussed earlier.
    In my view, the Mayo framework should be refined in
    limited respects. First, at step one of Mayo, the natural
    law cannot be claimed as such. See Gottschalk v. Benson,
    
    409 U.S. 63
    , 67 (1972). As Mayo noted, “Einstein could not
    patent his celebrated law that 
    E=mc2.” 566 U.S. at 71
    (quoting Diamond v. Chakrabarty, 
    447 U.S. 303
    , 309
    (1980)); see also Parker v. Flook, 
    437 U.S. 584
    , 591 (1978).
    Nor could a patent claimant “simply recite a law of nature
    and then add the instruction ‘apply the law,’” such as if
    Einstein had claimed “a process consisting of simply telling
    linear accelerator operators to refer to the law.” 
    Mayo, 566 U.S. at 78
    . Where the natural law itself is so broadly
    claimed, there is no reason to address step 2 (the inventive
    concept). The claims are simply ineligible.
    At the same time, “all inventions at some level embody,
    use, reflect, rest upon, or apply laws of nature, natural phe-
    nomena, or abstract ideas.” 
    Id. at 71.
    Thus, a sufficiently
    specific “application of a law of nature or mathematical
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               9
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    formula to a known structure or process may well be de-
    serving of patent protection.” 
    Id. (emphasis in
    original)
    (quoting Diamond v. Diehr, 
    450 U.S. 175
    , 187 (1981)).
    For there to be a patent eligible application of a natural
    law, there must be a “discover[y],” 35 U.S.C. § 101, and the
    claims must recite a specific application of that “discovery”
    with established utility. Otherwise, the natural law may
    be entirely preempted, even as to those aspects where the
    patent claimant has done no more than claim a broad con-
    ception. Requiring a specific application mitigates against
    the risk of granting patents too early—that is, before the
    patent applicant has devised a specific application of the
    natural law—and thereby prevents monopolization of the
    “basic tools of scientific and technological work.” 
    Mayo, 566 U.S. at 71
    (quoting 
    Benson, 409 U.S. at 67
    ); Brenner v.
    Manson, 
    383 U.S. 519
    , 534–35 (1966) (noting that before a
    claimed invention is sufficiently “refined and developed,”
    granting a patent “may confer power to block off whole ar-
    eas of scientific development”); see generally 
    Lemley, supra, at 1337
    –38 (arguing for a focus on claim scope under § 101
    and noting that overly broad claims “make later improve-
    ments more costly or even impossible”).
    The Supreme Court’s opinion in O’Reilly v. Morse, 56
    U.S. (15 How.) 62 (1854), the foundation of the Court’s ju-
    risprudence on patent eligibility, appears to make this very
    distinction. There, the Court allowed Morse’s narrower
    claims, which were tied specifically to his discovery: the tel-
    egraph. See 
    id. at 112.
    4 The Court reasoned that Morse
    4   For example, Morse’s second claim recited “the em-
    ployment of the machinery called the register or recording
    instrument, composed of the train of clock-wheels, cylin-
    ders, and other apparatus, or their equivalent, for remov-
    ing the material upon which the characters are to be
    imprinted, and for imprinting said characters,
    10          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    “discover[ed] a method by which intelligible marks or signs
    may be printed at a distance” and that “for the [particular]
    method or process thus discovered, he is entitled to a pa-
    tent.” 
    Id. at 117.
    But the Court held unpatentable Morse’s
    claim to all “marking or printing [of] intelligible characters,
    signs, or letters, at any distances” via electric currents, be-
    cause “the claim is too broad, and not warranted by law.”
    
    Id. at 112–13.
    As in Mayo, the Court was particularly con-
    cerned about preempting use of the natural phenomenon:
    “For aught that we now know some future inventor, in the
    onward march of science, may discover a [different] mode
    of writing or printing at a distance by means of the electric
    or galvanic current . . . . But yet if it is covered by this pa-
    tent the inventor could not use it, nor the public have the
    benefit of it without the permission of this patentee.” 
    Id. at 113.
        More recent opinions of the Supreme Court are also
    consistent with a focus on claims that sweep too broadly.
    In Benson, the Court observed that the claims were “so ab-
    stract and sweeping as to cover both known and unknown
    uses of” the mathematical formula at issue, and so held the
    claims 
    ineligible. 409 U.S. at 67
    –68. Similarly, in Flook,
    the claims to “a formula for computing an updated alarm
    limit” could “cover a broad range of potential uses” and
    were also held 
    ineligible. 437 U.S. at 586
    . By contrast, in
    Diehr, the Court held eligible claims that used a well-
    known mathematical equation in a process of curing syn-
    thetic 
    rubber. 450 U.S. at 191
    –92. The patent claimants
    did “not seek to pre-empt the use of th[e] equation,” but ra-
    ther sought “only to foreclose from others the use of that
    equation in conjunction with all of the other steps in their
    claimed process” for curing rubber. 
    Id. at 187.
    Thus, the
    substantially as set forth in the foregoing description of the
    second principal part of my invention.” 
    Morse, 56 U.S. at 85
    .
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    Supreme Court’s precedents support a requirement of spe-
    cific application as part of the patent eligibility inquiry as
    to natural laws.
    To ensure against overbroad claims, the scope of the
    § 101 natural law exception is necessarily informed by the
    utility requirement of § 101. The utility requirement has
    its origins in the constitutional grant of Congressional au-
    thority, which contemplated that the “discoveries” entitled
    to patents would be limited to those of proven utility. See
    U.S. Const. art. I, § 8, cl. 8; Sean M. O’Connor, The Over-
    looked French Influence on the Intellectual Property Clause,
    82 U. Chi. L. Rev. 733, 792–93 (2015). And the statutory
    requirement of utility has been held by the Supreme Court
    to require that the claimed invention have established util-
    ity, not merely the prospect of future utility. 
    Brenner, 383 U.S. at 534
    –36. In Brenner, the Supreme Court held that
    a patent claiming an allegedly novel process for making
    certain known steroids was ineligible for lack of utility. 
    Id. The Court
    reasoned that without a showing of utility, “the
    metes and bounds of th[e] monopoly are not capable of pre-
    cise delineation,” and “[s]uch a patent may confer power to
    block off whole areas of scientific development, without
    compensating benefit to the public.” 
    Id. at 534.
    “Unless
    and until a process is refined and developed to this point—
    where specific benefit exists in currently available form—
    there is insufficient justification for permitting an appli-
    cant to engross what may prove to be a broad field.” 
    Id. at 534–35.
    It follows that the scope of patents involving the
    application of natural laws should not extend beyond es-
    tablished utility, and that claims that extend further are
    not patent eligible. Under this approach, because of their
    breadth, the claims in Mayo would not be eligible at step
    one. See 
    Mayo, 566 U.S. at 87
    (explaining that the claim
    steps were “set forth in highly general language covering
    all processes that make use of the correlations after meas-
    uring metabolites, including later discovered processes
    that measure metabolite levels in new ways”).
    12          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    However, if the claim is sufficiently tied to a specific
    and useful application of a natural law at Mayo step one,
    that application itself should serve as the necessary in-
    ventive concept at Mayo step two. Yet at step two, the ap-
    plication must be more than determining the precise
    correlation of a known relationship using prior art pro-
    cesses, as was the case in Mayo itself. In Mayo, “scientists
    already understood that the levels in a patient’s blood of
    certain metabolites, including [those involved in the
    claims] were correlated with the likelihood that a particu-
    lar dosage of a thiopurine drug could cause harm or prove
    ineffective.” 
    Id. at 73–74.
    And “scientists routinely meas-
    ured metabolites as part of their investigations into the re-
    lationships between metabolite levels and efficacy and
    toxicity of thiopurine compounds.” 
    Id. at 79
    . “But those in
    the field did not know the precise correlations between me-
    tabolite levels and likely harm or ineffectiveness.” 
    Id. at 74.
    Thus, Mayo’s claims only involved determining the pre-
    cise correlations of a law of nature that was already well
    known. The asserted application of the natural law was
    therefore no more than determining “the precise correla-
    tions between metabolite levels and likely harm or ineffec-
    tiveness” of a drug dosage and thus was patent ineligible.
    Requiring specific and useful application for the entire
    scope of the claim at Mayo step one, and more than deter-
    mining precise correlations of a known natural law using
    prior art processes at Mayo step two, would ensure that the
    claims truly recite an “inventive application” of the natural
    law that should be eligible under § 101. This approach
    would help ensure that the reward of a patent goes to those
    who have actually done the work to develop a specific ap-
    plication of a natural law, not those who are the first to the
    patent office with broad, conceptual claims lacking proven
    utility in many applications.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            13
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    VI
    Finally, this case may involve claims that could be pa-
    tent eligible under this suggested approach. First, claims
    7–9 do not claim the natural law itself—the relationship
    between MuSK autoantibodies and MG, a rare neurological
    disorder—but rather claim specific methods of diagnosing
    neurological disorders like MG by detecting MuSK autoan-
    tibodies. See 
    Athena, 915 F.3d at 747
    . 5 Second, unlike in
    5   Claims 7–9 depend from claim 1, not at issue in this
    appeal, which recites:
    1. A method for diagnosing neurotransmission or
    developmental disorders related to [MuSK] in a
    mammal comprising the step of detecting in a bod-
    ily fluid of said mammal autoantibodies to an
    epitope of [MuSK].
    ’820 patent, col. 12, ll. 31–35.
    Claim 7 recites:
    7. A method according to claim 1, comprising
    contacting MuSK or an epitope or antigenic deter-
    minant thereof having a suitable label thereon,
    with said bodily fluid, immunoprecipitating any
    antibody/MuSK complex or antibody/MuSK
    epitope or antigenic determinant complex from
    said bodily fluid and
    monitoring for said label on any of said anti-
    body/MuSK complex or antibody/MuSK epitope or
    antigen determinant complex,
    wherein the presence of said label is indicative of
    said mammal is suffering from said neurotransmis-
    sion or developmental disorder related to [MuSK].
    
    Id. col. 12,
    l. 62–col 13, l. 5 (indentation added).
    14         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Mayo, this case involves a “discovery” of the relationship,
    not mere determination of the precise correlations of a
    known natural law using prior art processes. As the panel
    noted, “[p]rior to the[] discovery [by the named inventors],
    no disease had been associated with MuSK.” 
    Id. Because at
    least some of the claims here recite specific
    applications of the newly discovered law of nature with
    proven utility, this case could provide the Supreme Court
    with the opportunity to refine the Mayo framework as to
    diagnostic patents.
    Claim 8 depends from claim 7 and recites that the label
    is a radioactive label. 
    Id. col. 13,
    ll. 6–7. Claim 9 depends
    from claim 8 and further recites that the radioactive label
    is 125I. 
    Id. col 13,
    ll. 8–9.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    CHEN, Circuit Judge, concurring with denial of the petition
    for rehearing en banc.
    “Congress plainly contemplated that the patent laws
    would be given wide scope.” Bilski v. Kappos, 
    561 U.S. 593
    ,
    601 (2010) (quoting Diamond v. Chakrabarty, 
    447 U.S. 303
    ,
    308 (1980)). As the Court observed, “Congress took this
    permissive approach to patent eligibility to ensure that ‘in-
    genuity should receive a liberal encouragement.’” 
    Id. Con- sistent
    with that mandate, the Court in Diamond v. Diehr,
    
    450 U.S. 175
    (1981) adopted a relatively narrow and more
    2          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    administrable version of the judicial exceptions to the stat-
    utory text of 35 U.S.C. § 101 compared to what the Court
    articulated three years earlier in Parker v. Flook, 
    437 U.S. 584
    (1978). Under Diehr’s “claim as a whole” principle,
    which does not divide the claim into new versus old ele-
    ments, Athena’s claims, particularly claims 7 and 9, likely
    would have been found to be directed to a patent-eligible
    process comprising a set of technical, transformative steps
    to test a patient for a particular medical condition. But in
    Mayo Collaborative Services v. Prometheus Laboratories,
    Inc., 
    566 U.S. 66
    (2012), the Court set forth an inventive
    concept/point of novelty framework, which is a more far-
    reaching, aggressive version of the judicial exceptions to
    the statute and is largely incompatible with Diehr’s core
    rationale. At the same time, nothing in Mayo suggests that
    it sought to repudiate Diehr’s analysis. While I believe our
    court would benefit from the Supreme Court’s guidance as
    to whether it intended to override central tenets of Diehr,
    Mayo’s reasoning is clear and we are bound by it. Because
    that analysis requires the affirmance of the district court’s
    decision to invalidate Athena’s claims, I concur with this
    court’s decision to deny the petition for rehearing en banc.
    I. FLOOK AND DIEHR
    In Flook, the Court articulated the notion that some-
    thing else beyond an algorithm or law of nature recited in
    a claim must provide the key “inventive concept” to make
    a claim 
    patent-eligible. 437 U.S. at 594
    . There, the claims
    recited a formula for computing an updated alarm limit, a
    number that signals the presence of an abnormal temper-
    ature, pressure, and flow rate combination indicating inef-
    ficiency or perhaps danger during catalytic conversion
    processes. 
    Id. at 585.
    While the Court recognized that “a
    process is not unpatentable simply because it contains a
    law of nature or a mathematical algorithm,” 
    id. at 590,
    it
    also declared that “the discovery of such a phenomenon
    cannot support a patent unless there is some other in-
    ventive concept in its application.” 
    Id. at 594.
    Because the
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    recited field of use of catalytic conversion of hydrocarbons
    was “well known,” and the formula received no credit in the
    analysis, the Court concluded that Flook’s claim “contains
    no patentable invention.” 
    Id. The Court
    indicated that it
    had considered the claim “as a whole,” but it did so by re-
    viewing the claim on an element-by-element basis in
    search of something new and inventive, discounting the
    formula as “assumed to be within the prior art.” 
    Id. In so
    doing, the Court found no novel “inventive concept” in the
    claim. 
    Id. The Court
    advanced a very different analytic approach
    for the judicial exceptions in Diamond v. Diehr, 
    450 U.S. 175
    (1981), one that is difficult to reconcile with much of
    Flook’s reasoning. The Court held patent-eligible under
    § 101 a claim for a process of constantly measuring the
    temperature inside a molding press to determine when to
    remove a cured rubber product. 
    Id. at 192–93.
    The rela-
    tionship between temperature and cure relied on a known
    mathematical equation, but the Court found that, when the
    overall patent claim was considered as a whole, the re-
    spondents did “not seek to patent a mathematical formula,”
    but instead “[sought] protection for a process of curing syn-
    thetic rubber.” 
    Id. at 187.
    Rejecting a point of novelty in-
    quiry for § 101, the Court stated: “The ‘novelty’ of any
    element or steps in a process, or even of the process itself,
    is of no relevance in determining whether the subject mat-
    ter of a claim falls within the § 101 categories of possibly
    patentable subject matter.” 
    Id. at 188–89;
    id. at 193 
    n.15
    (“The fact that one or more of the steps in [a claimed] pro-
    cess may not, in isolation, be novel or independently eligi-
    ble for patent protection is irrelevant to the question of
    whether the claims as a whole recite subject matter eligible
    for patent protection under § 101.”) (emphasis in original);
    see also 
    id. at 190
    (“The question therefore of whether a
    particular invention is novel is ‘wholly apart from whether
    the invention falls into a category of statutory subject
    4           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    matter.’” (quoting In re Bergy, 
    596 F.2d 952
    , 961 (C.C.P.A.
    1979))).
    Furthermore, Bilski recognized the interplay between
    Diehr and Flook, pointing out that Diehr “established a
    limitation on the principles articulated in [Gottschalk v.]
    Benson and Flook” in that “Diehr emphasized the need to
    consider the invention as a whole, rather than ‘dissect[ing]
    the claims into old and new elements . . . in the analysis.’”
    
    Bilski, 561 U.S. at 611
    (quoting 
    Diehr, 450 U.S. at 188
    ).
    Thus, as recently as Bilski, the Court understood Diehr as
    requiring consideration of the claim as a whole, including
    any mathematical formula or scientific principle, in the
    § 101 inquiry, and as rejecting any dissection of the claim
    in search of novel or unconventional components.
    Aside from reaffirming the result in Flook, the Diehr
    Court addressed Flook’s takeaway meaning at two differ-
    ent points in the opinion. First, Diehr observed: “Our re-
    cent holdings in Gottschalk v. 
    Benson, supra
    , and Parker v.
    
    Flook, supra
    , both of which are computer-related, stand for
    no more than [the] long-established principles” that
    “[e]xcluded from such patent protection are laws of nature,
    natural phenomena, and abstract 
    ideas.” 450 U.S. at 185
    (citing Flook and other cases describing the judicial excep-
    tions, e.g., “[a] principle[] in the abstract . . . cannot be pa-
    tented.”). Second, Diehr explained the defect in the Flook
    claim in the following way: “A mathematical formula does
    not suddenly become patentable subject matter simply by
    having the applicant acquiesce to limiting the reach of the
    patent for the formula to a particular technological
    use . . . . All the application provided was a ‘formula for
    computing an updated alarm limit.’” 
    Id. at 192
    n.14 (quot-
    ing 
    Flook, 437 U.S. at 586
    ). The Diehr Court thus regarded
    the Flook claim as merely reciting a formula that would be
    applicable in an industrial process, but not reciting an
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              5
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    industrial process itself. 1 Aside from these two points,
    Diehr did not restate any other principles expressed in
    Flook.
    That Diehr established a limitation on Flook and re-
    jected the point of novelty/inventive concept approach to
    patent eligibility is underscored by the protests within the
    Diehr dissent. See 
    Diehr, 450 U.S. at 204
    –16. “Proper
    analysis,” in the dissent’s view, “must start with an under-
    standing of what the inventor claims to have discovered—
    or phrased somewhat differently—what he considers his
    inventive concept to be.” 
    Id. at 212.
    Because the claim had
    “no other inventive concept” other than the addition of a
    mathematical algorithm to the otherwise conventional
    claimed process for curing rubber, the dissent would have
    found the Diehr claim ineligible. 
    Id. at 213–14.
    The Diehr
    majority responded: “In order for the dissent to reach its
    conclusion it is necessary for it to read out of respondents’
    patent application all the steps in the claimed process
    which it determined were not novel or ‘inventive.’ That is
    not the purpose of the § 101 inquiry and conflicts with the
    proposition recited above that a claimed invention may be
    entitled to patent protection even though some or all of its
    elements are not ‘novel.’” 
    Id. at 193
    n.15.
    Given Diehr’s evident disagreement with Flook’s anal-
    ysis, Diehr, as the later opinion, was widely understood to
    be the guiding, settled precedent on § 101 for three dec-
    ades. See, e.g., Arrhythmia Research Tech., Inc. v. Corazo-
    nix Corp., 
    958 F.2d 1053
    , 1057 n.4 (Fed. Cir. 1992)
    1    Citing Flook, the Diehr Court also stated that “in-
    significant post-solution activity will not transform an un-
    patentable principle into a patentable process.” 
    Id. at 191–
    92. What that meant (pre-Mayo) was not clear, but, at the
    time, it could be read to refer to the fact that Flook’s claim
    did nothing more than “limit the use of the formula to a
    particular technological environment.” 
    Id. at 191.
    6          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    (“Although commentators have differed in their interpreta-
    tions of Benson, Flook, and Diehr, it appears to be generally
    agreed that these decisions represent evolving views of the
    Court, and that the reasoning in Diehr not only elaborated
    on, but in part superseded, that of Benson and Flook.”) (cit-
    ing R.L. Gable & J.B. Leaheey, The Strength of Patent Pro-
    tection for Computer Products, 17 Rutgers Computer &
    Tech. L.J. 87 (1991); D. Chisum, The Patentability of Algo-
    rithms, 47 U. Pitt. L. Rev. 959 (1986)); see also Edward W.
    Roush, Jr., Patent Law-Patentable Subject Matter-Manu-
    facturing Process Which Includes Use of Mathematical For-
    mula and Computer Program Constitutes Patentable
    Subject Matter, 13 St. Mary’s L.J. 420, 428–29 (1981) (“The
    Diehr Court’s holding is entirely consistent with title 35,
    section 101 subject matter standards. Although both the
    majority and dissent acknowledged that Diehr presented a
    section 101 statutory subject matter question, the dissent
    improperly injected considerations of section 102 novelty
    into its analysis. The majority in Flook employed the same
    rationale.”).
    II. MAYO AND ALICE
    Three decades after Diehr, Mayo provided a framework
    for the judicial exceptions that strongly tracked the reason-
    ing of Flook and the Diehr dissent. Mayo Collaborative
    Servs. v. Prometheus Labs., Inc., 
    566 U.S. 66
    (2012). The
    claims in Mayo were for a method of optimizing the treat-
    ment of an immune-mediated gastrointestinal disorder
    comprising two physical steps: (1) administering a syn-
    thetic drug to a patient, and (2) determining the concentra-
    tion level of certain metabolic byproducts in the patient’s
    bloodstream. The claims also included two “wherein”
    clauses, reciting that the measured level indicates whether
    the patient has received a safe and effective dose. 
    Id. at 74–75.
    The Court found that the “wherein” clauses incor-
    porate a law of nature: the relationship between concentra-
    tions of certain metabolites in the blood and the likelihood
    that a thiopurine drug dosage will prove ineffective or
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               7
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    cause harm. 
    Id. at 78.
    Because the two physical steps were
    well-known in the prior art, the Mayo Court characterized
    these claims as adding to that law of nature nothing more
    than “well-understood, routine, conventional activity.” 
    Id. at 73,
    79–80.
    Citing primarily to Flook, as well as Bilski, the Court
    stated that its prior decisions “insist that a process that fo-
    cuses upon the use of a natural law also contain other ele-
    ments or a combination of elements, sometimes referred to
    as an ‘inventive concept,’ sufficient to ensure that the pa-
    tent in practice amounts to significantly more than a pa-
    tent upon the natural law itself.” 
    Id. at 72–73.
    Because,
    in the Court’s view, “the steps in the claimed processes
    (apart from the natural laws themselves) involve well-un-
    derstood, routine, conventional activity previously engaged
    in by researchers in the field,” the claims lacked any in-
    ventive concept. 
    Id. at 73.
    Moreover, the Court did not
    share the concerns Diehr expressed as to preserving a doc-
    trinal distinction between §§ 101 and 102; instead, the
    Court noted: “We recognize that, in evaluating the signifi-
    cance of additional steps [beyond the law of nature] the
    § 101 patent eligibility inquiry and, say, the § 102 novelty
    inquiry might sometimes overlap.” 
    Id. at 90.
    Mayo’s ra-
    tionale thus follows the point of novelty/inventive concept
    reasoning of Flook and the Diehr dissent.
    As such, Mayo is in considerable tension with Diehr’s
    instruction to consider claims “as a whole” and Diehr’s dis-
    approval of dissecting claims into elements and ignoring
    non-novel elements in the § 101 
    analysis. 450 U.S. at 188
    .
    The Mayo Court indicated that it considered the claimed
    steps “as an ordered combination,” but it excluded the law
    of nature from that review and concluded that the “ordered
    combination adds nothing to the laws of nature that is not
    already present when the steps are considered 
    separately.” 566 U.S. at 79
    . In other words, after setting aside the law
    of nature, “any additional steps consist[ed] of well-under-
    stood, routine, conventional activity already engaged in by
    8           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    the scientific community; and those steps, when viewed as
    a whole, add[ed] nothing significant beyond the sum of
    their parts taken separately.” 
    Id. at 79
    –80. The Court
    found support for this understanding of the judicial excep-
    tions in Flook, observing that, for the Flook claim, the steps
    of monitoring a catalytic conversion process “were all ‘well
    known,’ to the point where, putting the formula to the side,
    there was no ‘inventive concept’ in the claimed application
    of the formula.” 
    Id. at 82.
    That type of “ordered combina-
    tion” review (“putting the formula to the side”), however, is
    fundamentally different from Diehr’s “claim as whole” prin-
    ciple, which does not carve out the judicial exception from
    the patent eligibility inquiry, nor does it dismiss elements
    that lack novelty. 2 See 
    Diehr, 450 U.S. at 188
    –93.
    2    Both Mayo and Flook rely on an 1841 English case,
    Neilson v. Harford, 1 Web. P. C. 295 (1841), as supporting
    an “inventive concept” requirement in which a law of na-
    ture is treated as something well-known. 
    Mayo, 566 U.S. at 82
    –83; 
    Flook, 437 U.S. at 592
    . There is reason to believe,
    however, that the decision in Neilson did not turn on such
    a premise. See Tilghman v. Proctor, 
    102 U.S. 707
    , 723–25
    (1880) (describing Neilson’s reasoning as drawing “the true
    distinction between a mere principle . . . and a process by
    which a principle is applied to effect a useful result.”); see
    also Brief of Professors Jeffrey A. Lefstin and Peter S. Men-
    ell as Amici Curiae in Support of Petition for Writ of Certi-
    orari at 15–21, Sequenom, Inc. v. Ariosa Diagnostics, Inc.
    (2016) (No. 15-1182) (Lefstin and Menell Br.). Moreover,
    no Supreme Court patent eligibility case for a process claim
    prior to Flook relied on an inventive concept inquiry or as-
    sumption that a scientific discovery should be regarded as
    well-known. See, e.g., Gottschalk v. Benson, 
    409 U.S. 63
    (1972); Expanded Metal Co. v. Bradford, 
    214 U.S. 366
    (1909); Dolbear v. Am. Bell Tel. Co., 
    126 U.S. 1
    (1888);
    Tilghman, 102 U.S. ; Cochrane v. Deener, 
    94 U.S. 780
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               9
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    In Alice, the Court reaffirmed this reversion to Flook,
    reiterating that, if the claims at issue are directed to laws
    of nature, natural phenomena, or abstract ideas, then we
    must ask “what else is there in the claims before us?” And
    in doing so, we must “consider the elements of each claim
    individually and ‘as an ordered combination’ to determine
    whether the additional elements ‘transform the nature of
    the claim’ into a patent-eligible application.” Alice Corp.
    Pty. v. CLS Bank Int’l, 
    573 U.S. 208
    , 217 (2014) (quoting
    
    Mayo, 566 U.S. at 78
    –79) (emphases added). As in Mayo,
    Alice described the second step of this analysis “as a search
    for an ‘inventive concept’” that discounts the law of nature
    or abstract idea from that inquiry. 
    Id. (quoting Mayo
    , 566
    U.S. at 72–73); see also 
    id. at 221
    (“A claim that recites an
    abstract idea must include ‘additional features’ to ensure
    ‘that the [claim] is more than a drafting effort designed to
    (1876); Corning v. Burden, 
    56 U.S. 252
    (1853); Le Roy v.
    Tatham, 
    55 U.S. 156
    (1853) (“A patent will be good, though
    the subject of the patent consists in the discovery of a great,
    general, and most comprehensive principle in science or
    law of nature, if that principle is by the specification ap-
    plied to any special purpose, so as thereby to effectuate a
    practical result and benefit not previously attained.” (quot-
    ing Househill Coal & Iron Co. v. Neilson, 1 Web. P. C. 673,
    683 (1843))); see also O’Reilly v. Morse, 
    56 U.S. 62
    , 114–
    15,118 (1853) (quoting same passage from Neilson quoted
    in Mayo and Flook, and then stating that “we see nothing”
    in Neilson “which would sanction the introduction of any
    new principle in the law of patents” and relying on “estab-
    lished principles in the American courts”). Importantly,
    Diehr’s reasoning, which post-dates Flook and was control-
    ling authority for 30 years, is incompatible with the in-
    ventive concept approach.
    10         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    monopolize the [abstract idea].’” (quoting 
    Mayo, 566 U.S. at 77
    )). 3
    When it comes to applying the judicial exceptions, it
    bears noting that the Mayo analytical approach is consid-
    erably harder to apply consistently than the Diehr frame-
    work, and more aggressive in its reach. Consider the claim
    in Mayo. If that claim had recited just the single step of
    administering a synthetic drug to a patient, that single-
    step claim would be patent-eligible, but lack novelty under
    § 102. And if that claim added a second step for determin-
    ing the subsequent level of a non-naturally occurring me-
    tabolite in a patient, that claim also would pass muster
    under § 101, but lack novelty. But when the claim further
    recites a relationship between a metabolite level and its ef-
    ficacy in a patient, that claim suddenly would be invalid
    under § 101 for violating the law of nature exception. In
    other words, steps 1 and 2 now get pushed aside and de-
    clared insignificant, and the last step is designated as the
    “focus” of the claim, i.e., the heart of the invention. The
    notion that adding claim language can convert an other-
    wise patent-eligible claim into a patent-ineligible claim is
    counterintuitive and a very difficult thing to explain to
    8,000 patent examiners. 4        Moreover, the process of
    3   The Alice Court, like Mayo and Flook, states that
    its approach is consistent with the rule that patent claims
    must be considered as a whole, because it considers the
    claim elements separately as well as in combination. 
    Alice, 573 U.S. at 218
    n.3. But, as 
    explained supra
    , this approach
    is wholly unlike Diehr’s understanding of evaluating the
    claim “as a whole.”
    4   That is not to say that the Mayo claim should have
    been upheld as valid. The “wherein” clauses simply iden-
    tified a mental inference from practicing a prior art pro-
    cess, which is insufficient to distinguish the claim from the
    prior art. See Brief for United States as Amicus Curiae, at
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            11
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    determining what the claim is “really about” when the
    claim is viewed in pieces, rather than as a whole, can be
    highly subjective and impressionistic. This approach puts
    courts and examiners in the position of assigning value
    judgments to individual limitations, designating some as
    “significant” and others as “insignificant,” and hoping eve-
    ryone else reaches the same conclusion as to whether the
    claim contains a truly meritorious inventive contribution
    as opposed to a judicial exception embellished with insig-
    nificant window dressing. And all this just to resolve the
    threshold question of whether an invention is eligible for
    the patent system.
    As written, Mayo requires a patent claim to have an
    inventive concept apart from the recitation of a natural
    law. That requirement has consequences that go beyond
    the facts of Mayo and is certainly clear enough that we are
    obliged to follow it. But, as explained above, Mayo’s frame-
    work is in tension on its face with Diehr, which was equally
    clear in requiring that a patent claim be considered as a
    whole, without putting aside any natural law or otherwise
    dissecting a claim into new versus old elements. Moreover,
    nothing in Mayo suggests that it sought to repudiate any-
    thing in Diehr; it instead suggests that it sought to main-
    tain continuity with the Court’s prior cases in this area. As
    for Flook, the Court in Bilski acknowledged that Diehr had
    “established a limitation” on Flook by “emphasiz[ing] the
    need to consider the invention as a whole, rather than ‘dis-
    sect[ing] the claims into old and new elements . . . in the
    analysis.’” 
    Bilski, 561 U.S. at 611
    (quoting 
    Diehr, 450 U.S. at 188
    ). Importantly, Mayo does not say that it nullified
    this key “limitation” expressed in Diehr. Furthermore, as
    Judge Dyk points out in his concurrence, the Court’s opin-
    ion in Ass’n for Molecular Pathology v. Myriad Genetics,
    26–28, Mayo v. Prometheus, 
    566 U.S. 66
    (2012) (No. 10-
    1150).
    12         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Inc., 
    569 U.S. 576
    (2013), which issued after Mayo, could
    be read as potentially maintaining an open door for diag-
    nostic claims such as Athena’s, because they may be re-
    garded as applications of knowledge of discovered natural
    laws. See Dyk Concurrence at 7. Myriad thus could sug-
    gest that Mayo should not go as far as its language indi-
    cates.
    Through it all, there is a serious question today in pa-
    tent law as to what extent Diehr remains good law in light
    of Mayo. We are not in a position to resolve that question,
    but the Supreme Court can. Resolution of the present con-
    fusion is important because if Mayo in fact overruled the
    principles in Diehr (as reiterated in Bilski), then that
    would be a significant incursion on the settled expectations
    that had existed for 30 years since Diehr. Relying on the
    Diehr framework, the Patent Office examined and granted
    many patents for medical diagnostic methods, establishing
    settled expectations in those granted property rights, and
    prompted companies and research institutions to organize
    their conduct and choices accordingly. Many of these diag-
    nostic claims, including the ones at issue here, do not hold
    up well against Mayo’s more searching, claim dissection
    scrutiny.
    III. ATHENA’S CLAIMS
    Judge Newman, Judge Moore, the petitioner, and the
    amici raise several valid concerns. But I believe the rea-
    soning underlying recent Supreme Court decisions compels
    us to affirm the district court’s invalidity determination
    here. While Diehr long established that we must evaluate
    “the claim as a whole” for § 101 purposes, that principle has
    been considerably undermined, for we’ve been recently in-
    structed to ask for claims such as Athena’s, “do the patent
    claims add enough to their statements of the correlations
    to allow the processes they describe to qualify as patent-
    eligible processes that apply natural laws?” 
    Mayo, 566 U.S. at 77
    (emphases in original). Moreover, “[p]urely
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              13
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    ‘conventional or obvious’ ‘[pre]-solution activity’ is nor-
    mally not sufficient to transform an unpatentable law of
    nature into a patent-eligible application of such a law.” 
    Id. at 79
    .
    It appears to me that, per Mayo, because the associa-
    tion of an antibody and a medical disorder is deemed to be
    a law of nature rather than an application of a law of na-
    ture, detecting that law of nature, by using data gathering
    steps or devices that can be said to be basic, conventional,
    or obvious, fails § 101. This is in contrast to examples, such
    as Diehr and Neilson, in which, as characterized by Mayo,
    the claimed inventions included unconventional steps be-
    yond reliance on an abstract scientific principle. 
    Mayo, 566 U.S. at 80
    –81, 83–84. In other words, the Supreme Court
    has made clear that detecting a law of nature (without
    more than conventional steps for accessing the law of na-
    ture) does not qualify as a patent-eligible application of a
    law of nature.
    Here, the inventors of Athena’s U.S. Patent No.
    7,267,820 discovered an association between the disorder
    myasthenia gravis and the presence of muscle specific ty-
    rosine kinase (MuSK) autoantibodies in a patient’s blood.
    At issue are claims 7–9 reciting:
    1. A method for diagnosing neurotransmission or
    developmental disorders related to muscle spe-
    cific tyrosine kinase (MuSK) in a mammal com-
    prising the step of detecting in a bodily fluid of
    said mammal autoantibodies to an epitope of
    muscle specific tyrosine kinase (MuSK).
    [...]
    7. A method according to claim 1, comprising
    contacting MuSK or an epitope or antigenic de-
    terminant thereof having a suitable label
    thereon, with said bodily fluid,
    14          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    immunoprecipitating any antibody/MuSK com-
    plex or antibody/MuSK epitope or antigenic de-
    terminant complex from said bodily fluid and
    monitoring for said label on any of said anti-
    body/MuSK complex or antibody/MuSK epitope
    or antigen determinant complex,
    wherein the presence of said label is indicative
    of said mammal is suffering from said neuro-
    transmission or developmental disorder related
    to [MuSK].
    8. A method according to claim 7 wherein said la-
    bel is a radioactive label.
    9. A method according to claim 8 wherein said la-
    bel is 125I.
    ’820 patent, col. 12 ll. 31–35, col. 12 l. 62 – col. 13 l. 9.
    We must accept that the association between the anti-
    body and the disorder is a law of nature. Here, as in Mayo,
    data first must be gathered in order to access and observe
    the newly-discovered law of nature, and the claimed steps
    “simply tell doctors to gather data from which they may
    draw an inference in light of the correlations.” 
    Mayo, 566 U.S. at 79
    . That claims 7 and 9 do not preempt all ways of
    observing the law of nature isn’t decisive, as none of the
    steps recited therein add anything inventive to the
    claims. Claim 7’s label-adding and immunoprecipitating
    steps are conventional, standard techniques in the art of
    detecting the presence of a law of nature such as a protein;
    the panel majority opinion notes that these steps do not re-
    cite any improvement in the underlying immunoassay
    technology. Athena Diagnostics, Inc. v. Mayo Collaborative
    Servs., LLC, 
    915 F.3d 743
    , 751 (Fed. Cir. 2019).
    Claim 9 recites use of a particular label, but one that
    was standard to use in the art. This cannot provide the
    inventive concept under Mayo. As an analogy, we would
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            15
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    not find that a claim directed to an abstract idea of com-
    municating information through a device passes muster
    under § 101 simply because it limits the claimed device to,
    say, a Samsung Galaxy® smartphone. Nor would the Mayo
    claim be considered to possess an inventive concept if it had
    recited that the initial step of “administering a drug” be
    performed in a conventional way, such as orally or intrave-
    nously.
    One amicus brief points out that § 101 provides that
    “[w]hoever invents or discovers” a new or useful process,
    manufacture, machine or composition of matter may be en-
    titled to a patent, and that § 100(a) defines “invention” to
    mean “invention or discovery.” Brief of Freenome Holdings
    Inc. and Achillion Pharm., Inc. as Amici Curiae in Support
    of Neither Party, Athena Diagnostics, Inc. v. Mayo Collab-
    orative Servs., LLC, 
    915 F.3d 743
    (2019) (No. 17-2508).
    Section 100 also defines “process” to include “a new use of
    a known process, machine, manufacture, composition of
    matter, or material.” § 100(b). Arguably, Athena’s inven-
    tion is a claim for a new use (diagnosing myasthenia gravis)
    of a known composition of matter (MuSK autoantibodies).
    Moreover, given that the dual “invention or discovery”
    structure consistently has been part of every Patent Act
    since 1790, this statutory provision suggests that at least
    some discoveries, including Athena’s “discovery” of how to
    diagnose myasthenia gravis, have always been contem-
    plated as patentable subject matter. See Lefstin and Men-
    ell Br. at 4–14. However, I am not aware of the Supreme
    Court ever addressing the meaning of “discovers” in § 101
    separately from “invents,” and it must be the Supreme
    Court, and not this court, that speaks to that statutory
    question, because the Court already proclaimed that
    “[g]roundbreaking, innovative, or even brilliant discovery
    does not by itself satisfy the section 101 inquiry.” 
    Myriad, 569 U.S. at 591
    .
    16         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    In sum, I do not think the claims here can withstand
    Mayo’s scrutiny. 5 But perhaps when read “as a whole” un-
    der Diehr, claims such as claims 7 and 9 in this case could
    be viewed as methods of testing for a specific medical con-
    dition, employing a sequence of steps that physically trans-
    form materials. By no means do the claims cover a natural
    principle in the abstract. Rather, this sounds like a contri-
    bution to the “useful arts” stated in Article I, Section 8,
    Clause 8 of the U.S. Constitution. That those physical,
    transformative steps may apply conventional techniques
    for locating an antibody in a sample would not be disre-
    garded in the threshold inquiry of whether the claimed in-
    vention qualifies as subject matter eligible for the patent
    system.
    New methods for diagnosing medical conditions, as a
    general matter, intuitively seem to be the kind of subject
    matter the patent system is designed for: to encourage the
    risky, expensive, unpredictable technical research and de-
    velopment that people would not otherwise pursue in the
    hope that if they discover something of great medical value,
    then they will be protected and rewarded for that success-
    ful effort with a patent. This category of invention, after
    all, is not the same as methods of entering into contracts,
    or horse whispering, or speed dating or other methods that
    animated many of the concerns underlying Bilski. The
    kind of lab work undertaken in discovering new diagnostics
    5  While this court is bound by Mayo, I do not believe
    this court has turned Mayo into a “per se rule” that bars all
    medical diagnostic claims from patent protection. Moore
    Dissent at 4. Diagnostic claims grounded in novel, non-ob-
    vious techniques that render a given diagnosis possess an
    inventive concept continue to be granted. As to the differ-
    ence in outcomes so far in our § 101 decisions between di-
    agnostic and treatment claims, I agree with the analysis in
    Judge Lourie’s concurrence. Lourie Concurrence at 3–4.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            17
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    and performing the steps of such claimed inventions can
    only be described as being technical in nature. For several
    decades before Mayo, this has been the basis for why the
    Patent Office granted patents for many medical diagnos-
    tics—not just for the law of nature in the abstract, but as
    applied in the real-world medical context to diagnose pa-
    tient health conditions. In any meaningful sense, this rep-
    resents a practical application of the discovered law of
    nature, that is, it is applied science in every sense of that
    term. And it should be patentable subject matter in a well-
    functioning patent system.
    CONCLUSION
    The most recent Supreme Court opinions are clear in
    my view on how to address claims like Athena’s. Even
    though Athena’s claims likely would be found patent-eligi-
    ble under Diehr’s framework, it is not an inferior court’s
    role to dodge the clear, recent direction of the Supreme
    Court. Accordingly, I concur with denial of the petition for
    rehearing en banc.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    MOORE, Circuit Judge, with whom O’MALLEY, WALLACH,
    and STOLL, Circuit Judges, join, dissenting from the denial
    of the petition for rehearing en banc.
    This is not a case in which the judges of this court dis-
    agree over whether diagnostic claims, like those at issue in
    Athena, should be eligible for patent protection. They
    should. None of my colleagues defend the conclusion that
    claims to diagnostic kits and diagnostic techniques, like
    those at issue, should be ineligible. The only difference
    among us is whether the Supreme Court’s Mayo decision
    2           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    requires this outcome. The majority of my colleagues be-
    lieve that our hands are tied and that Mayo requires this
    outcome. I believe Mayo does not. The Patent Act renders
    eligible the invention or discovery of any new and useful
    process. 35 U.S.C. § 101. And the patent system exists to
    promote exactly this sort of specific, targeted application of
    a life-saving discovery, which is characterized by extraor-
    dinarily high initial market entry costs. The claims in this
    case should be held eligible, and they are distinguishable
    from Mayo.
    DIAGNOSTICS ARE PER SE INELIGIBLE
    Since Mayo, we have held every single diagnostic claim
    in every case before us ineligible. See Cleveland Clinic
    Found. v. True Health Diagnostics LLC, 760 F. App’x 1013
    (Fed. Cir. 2019) (“Cleveland Clinic II”); Athena Diagnostics,
    Inc. v. Mayo Collaborative Servs., LLC, 
    915 F.3d 743
    (Fed.
    Cir. 2019); Roche Molecular Sys., Inc. v. CEPHEID, 
    905 F.3d 1363
    (Fed. Cir. 2018); Cleveland Clinic Found. v. True
    Health Diagnostics LLC, 
    859 F.3d 1352
    (Fed. Cir. 2017)
    (“Cleveland Clinic I”); Genetic Techs. Ltd. v. Merial L.L.C.,
    
    818 F.3d 1369
    (Fed. Cir. 2016); Ariosa Diagnostics, Inc. v.
    Sequenom, Inc., 
    788 F.3d 1371
    (Fed. Cir. 2015); In re
    BRCA1- and BRCA2-Based Hereditary Cancer Test Patent
    Litig., 
    774 F.3d 755
    (Fed. Cir. 2014); PerkinElmer, Inc. v.
    Intema Ltd., 496 F. App’x 65 (Fed. Cir. 2012). 1 Despite the
    1   The district courts are following our lead, holding
    diagnostic methods ineligible. See, e.g., Illumina, Inc. v.
    Ariosa Diagnostics, Inc., 
    356 F. Supp. 3d 925
    (N.D. Cal.
    2018); Genetic Veterinary Scis., Inc. v. LABOklin GmbH &
    Co., 
    314 F. Supp. 3d 727
    (E.D. Va. 2018); Mallinckrodt
    Hosp. Prods. IP Ltd. v. Praxair Distribution, Inc., No. 15–
    170–GMS, 
    2017 WL 3867649
    (D. Del. Sept. 5, 2017); Eso-
    terix Genetic Labs. LLC v. Qiagen Inc., No. 14–CV–13228–
    ADB, 
    2016 WL 4555613
    (D. Mass. Aug. 31, 2016); Esoterix
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            3
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    significance of these diagnostic inventions and the high
    costs of developing them, we have held, because of Mayo,
    every one of these life-changing inventions and discoveries
    ineligible. For example, we held a method for assessing a
    patient’s risk of having cardiovascular disease by detecting
    a specific enzyme, based on the discovery of the correlation
    between the enzyme and the disease, ineligible. Cleveland
    Clinic 
    I, 859 F.3d at 1363
    . Cardiovascular disease is the
    number one cause of death in the United States, killing
    more than 600,000 people per year, and costing over $200
    billion annually. 2 The diagnostic invention in Cleveland
    Clinic I allowed for early diagnosis of cardiovascular dis-
    ease and had a better predictive value than the clinically
    used risk factors employed by physicians at the time.
    There can be no argument but that such early diagnoses
    will save lives and reduce future treatment costs. But be-
    cause of Mayo, such claims were held ineligible. We also
    held ineligible claims to a method of screening for altera-
    tions in genes linked to hereditary breast and ovarian can-
    cer. In re 
    BRCA1, 774 F.3d at 765
    . It is estimated that
    breast cancer will kill more than 40,000 people in 2019. 3
    Again, there is no reasonable dispute that early diagnoses
    save lives and future medical costs. To be clear, the method
    claims were not to the gene itself which is found in nature,
    but rather to a use of the discovered correlation between
    Genetic Labs. LLC v. Qiagen Inc., 
    133 F. Supp. 3d 349
    (D.
    Mass. 2015); Genetic Veterinary Scis., Inc. v. Canine EIC
    Genetics, LLC, 
    101 F. Supp. 3d 833
    (D. Minn. 2015).
    2   CTRS. FOR DISEASE CONTROL AND PREVENTION,
    Heart    Disease    Fact    Sheet    (Aug.    23,    2017),
    https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_
    heart_disease.htm.
    3   NAT’L CANCER INSTITUTE, Cancer Stat Facts: Fe-
    male Breast Cancer, https://seer.cancer.gov/statfacts/html/
    breast.html.
    4           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    certain mutations and breast cancer for diagnostic pur-
    poses. In re 
    BRCA1, 774 F.3d at 758
    . We held ineligible a
    method for detecting tuberculosis, one of the world’s dead-
    liest diseases. 4 
    Roche, 905 F.3d at 1374
    . And claims to
    diagnostic methods related to fetal health, characteristics,
    and genetic disorders, such as Down syndrome, fared no
    better. 
    Ariosa, 788 F.3d at 1378
    ; PerkinElmer, 496 F. App’x
    at 73. The Ariosa method of detecting fetal abnormalities
    based on a simple blood test was an absolute game changer.
    Prior to the Ariosa discovery, such abnormalities were de-
    tected with higher cost and higher risk procedures such as
    amniocenteses which had the potential to harm all in-
    volved. That brings us to the Athena claims, which are di-
    rected to a method of diagnosing patients with an
    autoimmune disease using a protein that had never before
    been associated with the disease. 
    Athena, 915 F.3d at 747
    .
    One of every five patients with the autoimmune disease ex-
    perienced symptoms but did not produce the type of auto-
    antibodies previously associated with the disease, and thus
    were unable to be diagnosed and properly treated at an
    early stage. 
    Id. The claimed
    diagnostic method in Athena
    solved that problem through a specific, narrowly tailored
    diagnostic process but was nonetheless held ineligible.
    None of these diagnostic claims survived because we con-
    cluded we had no choice because of Mayo.
    We have turned Mayo into a per se rule that diagnostic
    kits and techniques are ineligible. That per se rule is “too
    broad an interpretation of this exclusionary principle
    [which] could eviscerate patent law.” Mayo Collaborative
    Services v. Prometheus Laboratories, Inc., 
    566 U.S. 66
    , 71
    (2012). The Supreme Court has repeatedly cautioned
    against rigid or per se rules. See, e.g., Halo Elecs., Inc. v.
    4   CTRS. FOR DISEASE CONTROL AND PREVENTION, Tu-
    berculosis (TB) Data and Statistics (Dec. 31, 2018),
    https://www.cdc.gov/tb/statistics/default.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               5
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    Pulse Elecs., Inc., 
    136 S. Ct. 1923
    , 1932 (2016) (rejecting
    test which “is unduly rigid”); Octane Fitness, LLC v. ICON
    Health & Fitness, Inc., 
    572 U.S. 545
    , 551 (2014) (rejecting
    test as “unduly rigid”); KSR Int’l Co. v. Teleflex Inc., 
    550 U.S. 398
    , 419–20 (2007) (cautioning against “[r]igid pre-
    ventative rules”); Festo Corp. v. Shoketsu Kinzoku Kogyo
    Kabushiki Co., 
    535 U.S. 722
    , 738 (2002) (preferring that
    rules be interpreted “in a flexible way, not a rigid one”);
    Warner-Jenkinson Co., Inc. v. Hilton Davis Chem. Co., 
    520 U.S. 17
    , 32 (1997) (declining to adopt a “rigid rule”); Dia-
    mond v. Chakrabarty, 
    447 U.S. 303
    , 315 (1980) (declining
    to create a rule that “inventions in areas not contemplated
    by Congress when the patent laws were enacted are un-
    patentable per se”).
    In his opening statement during The State of Patent
    Eligibility in America Senate hearings, Senator Coons rec-
    ognized that “for medical diagnostics, . . . [there is] a pre-
    sumption against eligibility that is nearly impossible to
    overcome.” The State of Patent Eligibility in America, Part
    I: Hearing Before the Subcomm. on Intellectual Property of
    the S. Comm. on the Judiciary, 116th Cong. 15:36–45
    (2019) (opening statement of Sen. Coons). And testimony
    from industry representatives confirmed that industry
    members and scholars think “it is unclear whether diag-
    nostic methods are patentable in any meaningful way.”
    See, e.g., The State of Patent Eligibility in America, Part II,
    116th Cong. 7 (2019) (written testimony of Hans Sauer,
    Ph.D., Deputy General Counsel and Vice President for In-
    tellectual Property, Biotechnology Innovation Organiza-
    tion (BIO)).
    Our fervor for clarity and consistency has resulted in a
    per se rule that excludes all diagnostics from eligibility. I
    do not agree with my colleagues that Mayo requires that
    all of these claims in all of these cases be held ineligible.
    But that is where we are.
    6           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    I do not fault my colleagues, who under protest have
    concluded that they have no choice but to hold the claims
    in Athena ineligible because of Mayo. See 
    Athena, 915 F.3d at 753
    n.4 (“[W]hether or not we as individual judges might
    agree or not that these claims only recite a natural law . . .
    the Supreme Court has effectively told us in Mayo that cor-
    relations between the presence of a biological material and
    a disease are laws of nature.”); see also Ariosa Diagnostics,
    Inc. v. Sequenom, Inc., 
    809 F.3d 1282
    , 1287 (Fed. Cir. 2015)
    (Lourie, J., concurring with denial of reh’g en banc) (“[I]t is
    unsound to have a rule that takes inventions of this nature
    out of the realm of patent-eligibility . . . [b]ut I agree that
    the panel did not err in its conclusion that under Supreme
    Court precedent it had no option other than to affirm the
    district court.”). There is surely some broad language in
    Mayo which could lead to this conclusion. I, however, think
    we have extended Mayo too far. Reading the entirety of
    Mayo and the subsequent Myriad decision, the Supreme
    Court did not intend Mayo to be the “sweeping” decision my
    colleagues have concluded it is. See, e.g., 
    Ariosa, 788 F.3d at 1380
    (Linn, J., concurring) (“I join the court’s opinion in-
    validating the claims . . . only because I am bound by the
    sweeping language of the test set out in [Mayo].”); 
    Ariosa, 809 F.3d at 1290
    n.3 (Dyk, J., concurring) (stating that we
    must “respect the sweeping precedent of Mayo”); see also
    
    id. at 1289
    (“[T]here is a problem with Mayo insofar as it
    concludes that inventive concept cannot come from discov-
    ering something new in nature . . . . Mayo did not fully
    take into account the fact that an inventive concept can
    come not just from creative, unconventional application of
    a natural law, but also from the creativity and novelty of
    the discovery of the law itself.”). It is the role of this court
    to both faithfully follow Mayo and to determine its reach
    when facts and circumstances differ. I dissent from my col-
    leagues’ refusal to rethink our interpretation of Mayo.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            7
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    DIAGNOSTICS DESERVE PATENT INCENTIVES
    “Diagnosis is the foundation of medicine,” and diagnos-
    tic techniques and kits when narrowly claimed are pre-
    cisely the type of innovation the patent system exists to
    promote. 5 Diagnostic techniques, while accounting for less
    than 2.5% of healthcare expenses, “guide[] approximately
    66% of clinical decisions.” 6 Diagnostics are an essential
    category of medical technologies, critical to treating ill-
    nesses and saving lives. Diagnostic medicine saves lives
    and money through early detection and reduces the need
    for high cost pharmaceuticals or curative procedures, but
    developing diagnostic kits and techniques is expensive and
    time consuming. Development of a new diagnostic test is
    estimated to cost up to $100 million and to take nearly 10
    years. 7
    5    NAT’L RESEARCH COUNCIL, TOWARD PRECISION
    MEDICINE: BUILDING A KNOWLEDGE NETWORK FOR
    BIOMEDICAL RESEARCH AND A NEW TAXONOMY OF DISEASE,
    Epilogue, (2011)       https://www.ncbi.nlm.nih.gov/books/
    NBK92141/.
    6   UP Rohr et al., The Value of In Vitro Diagnostic
    Testing in Medical Practice: A Status Report, PLOS ONE
    (March 2016), https://journals.plos.org/plosone/article?id=
    10.1371/journal.pone.0149856.
    7   I. Okeke et al., Diagnostics as Essential Tools for
    Containing Antibacterial Resistance, 14 DRUG RESISTANCE
    UPDATES 95, 101 (April 2011), https://www.sciencedi-
    rect.com/science/article/pii/S1368764611000185?via%3Di-
    hub; see also Mystery Solved! What is the Cost to Develop
    and Launch a Diagnostic, DIACEUTICS (Jan. 15, 2013),
    https://www.diaceutics.com/?expert-insight=mystery-
    solved-what-is-the-cost-to-develop-and-launch-a-diagnos-
    tic (2013) (The average cost of developing a diagnostic in
    the U.S. is $50–75 million with development of expansion
    8          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Diagnostics economically depend on strong patent pro-
    tection. Because they are typically characterized as “very
    expensive to develop but relatively cheap to reproduce,” pa-
    tent protection is required to make it financially viable for
    continued investment in their development. 8 As Senator
    Tillis explained in his opening statement during The State
    of Patent Eligibility in America Senate hearings, “[w]hy
    would anyone in their right mind risk millions if not bil-
    lions of dollars to develop a product when they have no idea
    if they’re eligible for protection? From a business perspec-
    tive, it simply isn’t worth the risk for many endeavors.” 9
    Without the possibility of patent protection to recoup the
    high costs of research and development associated with di-
    agnostic techniques and kits, the impact can only be that
    there will be fewer advances in diagnostic medicine. 10 In-
    dustry leaders make clear that absent dependable patent
    assays on existing platforms costing $10–15 million and de-
    velopment of new platforms costing over $100 million.).
    8  A. Krattiger, Promoting Access to Medical Innova-
    tion, WORLD INTELLECTUAL PROPERTY ORGANIZATION (Sept.
    2013), https://www.wipo.int/wipo_magazine/en/2013/05/ar-
    ticle_0002.html.
    9  The State of Patent Eligibility in America, Part I,
    116th Cong. 3:32–47 (2019) (opening statement of Sen. Til-
    lis).
    10 The State of Patent Eligibility in America, Part II,
    116th Cong. 1–2 (2019) (written testimony of Rick Bran-
    don, Associate. General Counsel, University of Michigan
    representing Association of American Universities)
    (“[I]nventors and investors often require the protection of a
    period of exclusivity in order to assume the substantial risk
    of investing the significant resources needed in order to
    bring a product to the public. In the case of products that
    require FDA approval, including diagnostics, this can take
    years and millions of dollars. The public benefits from both
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE               9
    SERVICES
    protection, companies will not move forward with diagnos-
    tic innovations. 11 As investors routinely recognize, once
    patent protection over medical technologies is lost, these
    innovations essentially become gifts to society and the com-
    panies that developed them cannot recoup the time and
    money they spent to do so. 12 It is these life-saving fields
    though, with such high costs to the initial market investor,
    where patent protection is critical.
    The importance of diagnostics and their cost-reducing
    effects on patient treatment cannot reasonably be ques-
    tioned. We are hard-pressed to identify facets of modern
    medicine that do not employ or rely on diagnostics. Diag-
    nostics are “crucial in mitigating the effect of disease out-
    breaks.” 13 For example, had diagnostic techniques been
    public disclosure and a greater assurance of new products
    and services.”).
    11  The State of Patent Eligibility in America, Part III,
    116th Cong. 3 (2019) (written testimony of Peter O’Neill,
    Executive Director of Cleveland Clinic Innovations) (The
    “[a]bility to get protectable intellectual property (usually in
    the form of a patent) is the first, and most influential factor
    in our assessment. If an invention can’t get intellectual
    property protection, usually that is a fatal flaw and the in-
    vention is abandoned at that point.”).
    12  M. Rosenblatt, The Real Cost of “High-Priced”
    Drugs, HARVARD BUSINESS REVIEW (Nov. 17, 2014),
    https://hbr.org/2014/11/the-real-cost-of-high-priced-drugs;
    The State of Patent Eligibility in America, Part I, 116th
    Cong. 1–2 (2019) (written testimony of Patrick Kilbride,
    Senior Vice President of the Global Innovation Policy Cen-
    ter at the U.S. Chamber of Commerce).
    13  M. Perkins et al., Diagnostic Preparedness for In-
    fectious Disease Outbreaks, 390 SCIENCEDIRECT 2211
    10          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    developed before the 2015 Ebola outbreak, and applied to
    patients early enough, the population-attack rate of Ebola
    could have been reduced from 80% to 0%. 
    Id. Ebola is
    only
    one example. “Poor diagnostic preparedness has [also] con-
    tributed to significant delays in the identification of . . .
    Lassa Fever, yellow fever, and Zika.” 14 Disease epidemics
    are not the only life-threatening conditions to which diag-
    nostics provide a meaningful response. Diagnostics are
    pivotal to addressing the advent and increase in drug-re-
    sistant infections. Current estimates project that by 2050,
    drug-resistant infections will “lead to 10 million people dy-
    ing every year and . . . would cost the world up to 100 tril-
    lion” dollars. 15 Diagnostic tests are a critical component of
    the answer to this problem. Methicillin-Resistant Staphy-
    lococcus Aureus (“MRSA”) is an example of an antibiotic-
    resistant infection that burdens American hospitals in
    terms of morbidity, mortality, and healthcare costs. 16 Its
    treatment, and the outcome of that treatment, depends on
    appropriate diagnosis and antibiotic administration. 
    Id. And the
    effects of diagnostics in improving the detection
    and treatment of cancer, human immunodeficiency virus,
    (2017), https://www.thelancet.com/journals/lancet/article/
    PIIS0140-6736(17)31224-2/fulltext.
    14  C. Kelly-Cirino et al., Importance of Diagnostics in
    Epidemic and Pandemic Preparedness, 4 BMJ GLOBAL
    HEALTH (2019),        https://gh.bmj.com/content/4/Suppl_2/
    e001179.
    15  J. O’Neill, Antimicrobial Resistance: Tackling a cri-
    sis for the health and wealth of nations, THE REV. ON
    ANTIMICROBIAL RESISTANCE, 6 (Dec. 2014).
    16  K. Bauer et al., An Antimicrobial Stewardship Pro-
    gram’s Impact with Rapid Polymerase Chain Reaction
    Methicillin-Resistant Staphylococcus Aureus/S. aureus
    Blood Culture Test in Patients with S. aureus Bacteremia,
    51 CLINICAL INFECTIOUS DISEASES 1074 (2010).
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE             11
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    as well as in vitro care should not be overlooked. See Rohr,
    supra note 6. For example, diagnostics improved medical
    approaches to cancer care, and will continue supporting
    progress in a field that cost an estimated $125 billion in the
    United States in 2010. 17 Development of diagnostics plays
    a central role in American medical innovation as we face
    increasingly robust medical challenges, with a goal to save
    lives and improve the quality of those lives.
    Not only do diagnostics save lives, they reduce the cost
    of treatment. The diagnostic industry drives medical costs
    down, not up. People suffering from illness or disease will
    do whatever they can to find a cure. Proper diagnoses al-
    low for earlier detection of illness and targeted treatment.
    But without proper diagnosis, patients have to endure nu-
    merous unsuccessful and costly treatments. Both the fi-
    nancial burden of continued testing and treatment and the
    emotional and physical tolls associated with suffering from
    symptoms, but not knowing the cause, can be reduced or
    even prevented thanks to diagnostics. And when there are
    specific advances, discoveries, or inventions in the diagnos-
    tics industry, they must be eligible for patent protection. 18
    17   A. Mariotto et al., Projections of the Cost of Cancer
    Care in the United States: 2010-2020, 103 J. NAT’L CANCER
    INST. 117, 122 (2011), https://www.ncbi.nlm.nih.gov/pmc/
    articles/PMC3107566/.
    18   See R. Davis, Senate Scrutinizes Patent Bill’s Effect
    on Drug Prices, Genes, LAW360 (June 6, 2019),
    https://www.law360.com/ip/articles/1164262/senate-scruti-
    nizes-patent-bill-s-effect-on-drug-prices-genes?nl_pk=
    c4844ff4-19ab-48d7-b2f9-9fa06ce87648&utm_source=
    newsletter&utm_medium=email&utm_campaign=ip (dis-
    cussing Senator Tillis’ explanation that patent eligibility
    uncertainty “has undermined investment in new medical
    research and could prevent new drugs from being created,
    making it a moot point how much they cost”).
    12           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    Unless one opposes the notion of patent protection en-
    tirely, it cannot be reasonably disputed that claims to diag-
    nostic kits and techniques, like pharmaceuticals, which
    require enormous initial investments in terms of both time
    and money, are the reason we suffer the promise of a mo-
    nopoly. As many have explained, without patent protec-
    tion, there will be little incentive for companies to invest
    the monumental amount of time and money necessary to
    develop diagnostic kits, tools and techniques. A recent ar-
    ticle, co-written by Paul Michel, former Chief Judge of the
    Federal Circuit, and David Kappos, former Director of the
    PTO, states:
    This uncertain patent climate has a chilling effect
    on innovation in biosciences to the detriment of
    public health. . . . [I]nvestors are less interested in
    funding costly new biomarker diagnostic research.
    As a result, diseases will go undiagnosed, and pa-
    tients will suffer the consequences. . . . Investment
    in diagnostics goes to the core of containing spiral-
    ing health care costs, improving patient outcomes
    and treating illnesses before they become debilitat-
    ing to suffering Americans. 19
    This sentiment was echoed by industry leaders during The
    State of Patent Eligibility in America Senate hearings held
    on June 4–5 & 11, 2019. See The State of Patent Eligibility
    in America, Part II, 116th Cong. 6–7 (2019) (written testi-
    mony of Hans Sauer, Ph.D., Deputy General Counsel and
    Vice President for Intellectual Property, BIO) (“Absent the
    ability to protect their discoveries with valid patents . . .
    19 D. Kappos & P. Michel, Supreme Court Patent De-
    cisions are Stifling Health Care Innovation, MORNING
    CONSULT (Oct. 29, 2018), https://morningconsult.com/opin-
    ions/supreme-court-patent-decisions-stifling-health-care-
    innovation/.
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE                13
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    companies would lack the necessary incentive to make the
    risky, expensive, and time-consuming investments in re-
    search and development often required to bring new tech-
    nologies to market.”); The State of Patent Eligibility in
    America, Part II, 116th Cong. 9 (2019) (written testimony
    of Henry Hadad, President, IPO) (“[C]onfusion about what
    is patent-eligible discourages inventors from pursuing
    work in certain technology areas, including discovering
    new genetic biomarkers and developing diagnostic and ar-
    tificial intelligence technologies. [This] uncertainty disin-
    centivizes the enormous investment in research and
    development that is necessary to fuel the innovation cy-
    cle.”); The State of Patent Eligibility in America, Part I,
    116th Cong. 14:46–15:05 (2019) (opening statement of Sen.
    Coons) (“I worry that this continuing lack of clarity . . . has
    led to reduced investment in the expensive and intensive
    research and development necessary to develop next gen-
    eration cures . . . .”); The State of Patent Eligibility in Amer-
    ica, Part III, 116th Cong. 1:22:12–1:22:35 (2019) (testimony
    of Peter O’Neill, Executive Director of Cleveland Clinic In-
    novations) (“The work of translating discovery into com-
    mercial products requires [patent] protection to justify the
    investment into those discoveries. And absent clarity . . .
    we are not moving forward diagnostic discoveries to trans-
    late them into commercial products the way we would do
    otherwise.”); The State of Patent Eligibility in America,
    Part III, 116th Cong. 1:42:12–1:42:28 (2019) (testimony of
    Corey Salsberg, Vice President and Global Head Intellec-
    tual Property Affairs for Novartis) (“Make no mistake
    about section 101, this is the gateway to the patent system.
    So what that means in practical terms is it’s a guide as to
    which fields of technologies can support sustained invest-
    ment, and which ones likely cannot, and that’s why we
    have such deep concerns about the status quo.”); The State
    of Patent Eligibility in America, Part III, 116th Cong. 1
    (2019) (written testimony of Robert Deberardine, Chief In-
    tellectual Property Counsel, Johnson & Johnson) (“It is
    only because of the United States patent system, and the
    14          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    predictability that it has historically provided, that we
    have been able to make the investments, conduct the re-
    search, and take the risks required to develop these treat-
    ments. And only with predictability will we be able [to]
    solve today’s most challenging healthcare problems and de-
    velop the groundbreaking treatments of tomorrow. Unfor-
    tunately, the patent system in the United States today is
    anything but predictable.”).
    The math is simple, you need not be an economist to
    get it: Without patent protection to recoup the enormous
    R&D cost, investment in diagnostic medicine will decline.
    To put it simply, this is bad. It is bad for the health of the
    American people and the health of the American economy.
    And it is avoidable depending on our interpretation of the
    Supreme Court’s holding in Mayo. I have no doubt that my
    colleagues agree with the sentiments herein that diagnos-
    tics are important, and that patent protection of such diag-
    nostics is critical to incentivizing their very existence. The
    only point upon which we disagree is over the breadth of
    the Mayo holding.
    ATHENA’S SPECIFICALLY CLAIMED METHOD IS ELIGIBLE
    While Mayo did not require the result the panel
    reached in this case, the panel could not disregard our
    binding precedent of cases like Ariosa, Cleveland Clinics,
    and Roche which have interpreted Mayo as requiring this
    per se rule. Thus, the only hope was en banc action.
    It is my view that § 101 and Mayo, when read together
    and in their entireties, compel the holding that the claims
    in Athena are eligible. Under the Patent Act, “[w]hoever
    invents or discovers any new and useful process, machine,
    manufacture, or composition of matter, or any new and
    useful improvement thereof, may obtain a patent therefor,
    subject to the conditions and requirements of this title.” 35
    U.S.C. § 101. Our decisions have ignored the truth that
    claims to specific, narrow processes, even if those processes
    involve natural laws, are not directed to the natural laws
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              15
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    themselves. And contrary to the “elementary principle
    that . . . [we must] ‘give effect, if possible, to every clause
    and word of a statute,’” our § 101 jurisprudence has largely
    ignored Congress’ explicit instruction that a discovery can
    be the basis for a patentable invention. King v. Burwell,
    
    135 S. Ct. 2480
    , 2498 (2015) (quoting Montclair v.
    Ramsdell, 
    107 U.S. 147
    , 152 (1883)). Section 101 refers to
    both “invent[ion] or discover[y],” and § 100(a) expressly de-
    fines invention as any “invention or discovery.” We have
    misread Mayo and how it fits within the framework of the
    judicially-created exceptions to § 101 for laws of nature,
    natural phenomena, and abstract ideas.
    Laws of nature, natural phenomena, and abstract
    ideas are considered “the basic tools of scientific and tech-
    nological work.” Alice Corp. Pty. Ltd. v. CLS Bank Int’l,
    
    573 U.S. 208
    , 216 (2014) (quoting Assoc. for Molecular Pa-
    thology v. Myriad Genetics, Inc., 
    569 U.S. 576
    , 589
    (2013)). The Supreme Court excepted these categories
    from § 101 to ensure that patent law does not “‘inhibit fur-
    ther discovery by improperly tying up the future use of’
    these building blocks of human ingenuity.” 
    Id. (quoting Mayo
    , 566 U.S. at 85). Accordingly, “patents cannot issue
    for the discovery” of a law of nature. Funk Bros. Seed Co.
    v. Kalo Inoculant Co., 
    333 U.S. 127
    , 130 (1948). Nor can a
    claim to the law of nature become patentable by simply
    “adding the words ‘apply it.’” 
    Mayo, 566 U.S. at 72
    (citing
    Gottschalk v. Benson, 
    409 U.S. 63
    , 71–72 (1972)). But “an
    application of a law of nature . . . to a known structure or
    process may well be deserving of patent protection.” 
    Id. at 71
    (quoting Diamond v. Diehr, 
    450 U.S. 175
    , 187 (1981)).
    We have chosen to ignore the legal space between these
    principles in favor of a swiftly executing, per se rule that
    all diagnostic claims are ineligible. That conclusion is in-
    correct.
    By distinguishing between claims that recite a law of
    nature and simply add the words “apply it,” and claims that
    16          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    recite a concrete application of a law of nature, the Su-
    preme Court suggests we should consider the level of spec-
    ificity in the claims to determine whether the claim is even
    directed to the natural law. See 
    Alice, 573 U.S. at 223
    (“[I]f
    a patent’s recitation of a computer amounts to a mere in-
    struction to implement an abstract idea on a computer,
    that addition cannot impart patent eligibility.”)); 
    Mayo, 566 U.S. at 72
    (“[T]o transform an unpatentable law of na-
    ture into a patent-eligible application of such a law, one
    must do more than simply state the law of nature while
    adding the words ‘apply it.’”); 
    Diehr, 450 U.S. at 192
    (“[W]hen a claim recites a mathematical formula (or scien-
    tific principle or phenomenon of nature), an inquiry must
    be made into whether the claim is seeking patent protec-
    tion for that formula in the abstract. . . . [W]hen a claim
    containing a mathematical formula implements or applies
    that formula in a structure or process which, when consid-
    ered as a whole, is performing a function which the patent
    laws were designed to protect (e.g., transforming or reduc-
    ing an article to a different state or thing), then the claim
    satisfies the requirements of § 101.”).
    The law of nature at issue in Mayo was the “relation-
    ship between concentrations of certain metabolites in the
    blood and the likelihood that a dosage of a thiopurine drug
    will prove ineffective or cause 
    harm.” 566 U.S. at 77
    . Im-
    portantly, this relationship was not a new discovery. “At
    the time the discoveries embodied in the patents were
    made, scientists already understood that the levels in a pa-
    tient’s blood of certain metabolites . . . were correlated with
    the likelihood that a particular dosage of thiopurine drug
    could cause harm or prove ineffective.” 
    Id. at 73.
    While
    the inventors characterized the precise correlation, they
    could not be said to have discovered the relationship in the
    first place.
    The Court began its analysis with the statement that
    “[i]f a law of nature is not patentable, then neither is a pro-
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            17
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    cess reciting a law of nature, unless that process has addi-
    tional features that provide practical assurance that the
    process is more than a drafting effort designed to monopo-
    lize the law of nature itself.” 
    Id. at 77–78.
    It examined the
    limitations of the representative claim, which recited:
    A method of optimizing therapeutic efficacy for
    treatment of an immune-mediated gastrointestinal
    disorder, comprising:
    (a) administering a drug providing 6-thi-
    oguanine to a subject having said immune-
    mediated gastrointestinal disorder; and
    (b) determining the level of 6-thioguanine
    in said subject having said immune-medi-
    ated gastrointestinal disorder,
    wherein the level of 6-thioguanine less
    than about 230 pmol per 8×108 red blood
    cells indicates a need to increase the
    amount of said drug subsequently adminis-
    tered to said subject and
    wherein the level of 6-thioguanine greater
    than about 400 pmol per 8×108 red blood
    cells indicates a need to decrease the
    amount of said drug subsequently adminis-
    tered to said subject.
    
    Id. at 74–75.
        This claim in its entirety did nothing more than de-
    scribe the natural relationship between metabolite concen-
    trations and the effective dose of a thiopurine drug. 
    Id. at 77.
    “Unlike, say, a typical patent on a new drug or a new
    way of using an existing drug, the patent claims d[id] not
    confine their reach to particular applications of those
    laws.” 
    Id. at 87.
    The claimed steps were set forth in “highly
    general language covering all processes that make use of
    the correlations . . . including later discovered processes
    18          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    that measure metabolite levels in new ways.” 
    Id. at 87.
    Due to their breadth, the Supreme Court concluded that
    upholding the claims “would risk disproportionately tying
    up the use of the underlying natural laws, inhibiting their
    use in the making of further discoveries.” 
    Id. at 73;
    see also
    
    id. at 87
    (holding that “the basic underlying concern that
    these patents tie up too much future use of laws of nature”
    reinforced the holding of ineligibility). “[S]imply append-
    ing conventional steps, specified at a high level of general-
    ity,” to the law of nature did not make that law patentable.
    
    Id. at 82
    (emphasis added).
    The breadth and generality of the Mayo claims led to
    their demise, as they recited nothing more than the natural
    law. We have since ignored these considerations, treating
    every claim that includes a law of nature as directed to that
    law, even if the claim as a whole recites a specific way of
    applying that law of nature to a new and useful end. We
    should not ignore the considerations related to claim
    breadth articulated in Mayo in our § 101 analysis.
    The Athena claims differ significantly from the Mayo
    claims. In 1960, before the invention claimed in U.S. Pa-
    tent No. 7,267,820 (“the ’820 patent”), scientists identified
    a specific category of autoantibodies that bind to and inter-
    fere with the acetyl choline receptor (AChR)—which is re-
    sponsible for the transmission of signals from neurons to
    muscle cells—cause Myasthenia gravis (“MG”). ’820 patent
    at 1:24–26. The presence of these anti-AChR antibodies
    thus indicates that the patient suffers from MG. However,
    20% of patients who manifested MG-like symptoms did not
    have the anti-AChR antibodies. 
    Id. at 1:34–40.
    It was un-
    known if this 20%, “have the same or a distinct and sepa-
    rate MG condition,” 
    id. at 1:41–42,
    and there was “no basis
    for providing an immediate clinical diagnosis for such pa-
    tients,” 
    id. at 4:20–22.
        The inventors of the ’820 patent discovered that a dif-
    ferent type of autoantibody that binds to and interferes
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    with muscle-specific tyrosine kinase (MuSK)—another re-
    ceptor also known to help transmit signals from neurons to
    muscles—can also cause MG. 
    Id. at 1:54–61
    (“The present
    inventors surprisingly found that many of the 20% of MG
    patients which do not exhibit any autoantibodies to AChR,
    instead have IgG antibodies . . . indicating that they are
    afflicted with a form of MG which has a different etiology .
    . . .”). The inventors in Athena discovered that these MG
    sufferers produced the anti-MuSK antibody, and created a
    process for diagnosing MG using methods that detect the
    presence of that antibody. These methods had never before
    been used to diagnose MG. Claims 7 and 9, on which the
    majority focused in Athena, require the use of specific la-
    boratory techniques to diagnose a patient based on the nat-
    ural law that 20% of people having MG produce
    autoantibodies to the MuSK protein. Claim 7 recites:
    1. A method for diagnosing neurotransmission or
    developmental disorders related to muscle specific
    tyrosine kinase (MuSK) in a mammal comprising
    the step of detecting in a bodily fluid of said mam-
    mal autoantibodies to an epitope of muscle specific
    tyrosine kinase (MuSK).
    7. A method according to claim 1, comprising con-
    tacting MuSK or an epitope or antigenic determi-
    nant thereof having a suitable label thereon, with
    said bodily fluid, immunoprecipitating any anti-
    body/MuSK complex or antibody/MuSK epitope or
    antigenic determinant complex from said bodily
    fluid and monitoring for said label on any of said
    antibody/MuSK complex or antibody/MuSK
    epitope or antigen determinant complex, wherein
    the presence of said label is indicative of said mam-
    mal is suffering from said neurotransmission or de-
    velopmental disorder related to muscle specific
    tyrosine kinase (MuSK).
    ’820 patent at Claims 1, 7.
    20          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    The claims provide for a method of diagnosing patients
    with MG using the following concrete steps: (1) contacting
    the patient’s bodily fluid with labeled MuSK, MuSK
    epitope, or other antigenic determinant that binds any
    anti-MuSK antibodies that may be present in the bodily
    fluid; (2) immunoprecipitating any resulting complexes
    from the bodily fluid; and (3) detecting the presence of the
    anti-MuSK antibody by monitoring for the label, whereby
    the presence of the label indicates a diagnosis of MG. 
    Id. These steps
    are not set out at the “high level of generality”
    that concerned the Court in Mayo, and they specifically
    confine their reach to a specific application of the relation-
    ship between anti-MuSK antibodies and MG. While the
    combination of steps in Mayo amounted to little “more than
    an instruction to doctors to apply the applicable laws when
    treating their 
    patients,” 566 U.S. at 79
    , claim 7 in Athena
    is a single, specific method for applying the applicable law.
    Indeed, the majority in this case repeatedly acknowl-
    edged that the claims in Athena, unlike the claims in Mayo,
    contain specific, concrete steps applying the law of nature.
    See, e.g., 
    Athena, 915 F.3d at 751
    (“The claims at issue here
    involve both the discovery of a natural law and certain con-
    crete steps to observe its operation.”). As the majority fur-
    ther acknowledged, claim 9, which depends on claim 7,
    “leaves open to the public other ways of interrogating the
    correlation between MuSK autoantibodies and MuSK-re-
    lated disorders without practicing the claim’s concrete
    steps.” 
    Id. at 752.
    In fact, the ’820 patent identifies alter-
    nate methods for detecting antibodies, such as MuSK-re-
    lated antibodies. See ’820 patent at 3:33–4:12. The claims
    do not “broadly preempt the use of a natural law,” and do
    not prevent any scientist from using the natural law in as-
    sociation with other common processes. 
    Mayo, 566 U.S. at 72
    ; see 
    Myriad, 569 U.S. at 595
    –96. The concreteness and
    specificity of the claims in Athena moves them from recit-
    ing a law of nature to a particular application of a law of
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE             21
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    nature. The claims are not directed to a natural law or
    phenomenon.
    The inventiveness of the claimed discovery in the pro-
    cess steps should also be considered when assessing eligi-
    bility. New and useful discoveries, such as the before
    unknown relationship between anti-MuSK autoantibodies
    and MG, when applied in a “process,” should pass muster
    as eligible under the statutory text of § 101. Our decision
    to entirely disregard the discovery incorporated in the
    claims is a misapplication of the statute. This is not to say
    that a claim on the discovery of a law of nature itself or a
    natural phenomenon should be eligible. I agree it should
    not. But to wholly ignore the inventiveness of the discovery
    when assessing patent eligibility closes our eyes to the stat-
    ute enacted by Congress. Athena discovered that 20% of
    people suffering from MG generate autoantibodies that
    bind to a MuSK protein. Its claims recite concrete steps to
    detect the presence of autoantibodies to MuSK to diagnose
    MG. These antibody/MuSK complexes had never been
    used by prior art MG diagnostic tests. In contrast, the
    claims in Mayo recited a generic “determining” step, with
    no laboratory test at all specified by the claims, and the
    specification itself stated that the methods were “well-un-
    derstood, routine, and conventional activity already en-
    gaged in by the scientific 
    community.” 566 U.S. at 79
    .
    Moreover, the Court explained that scientists had rou-
    tinely performed that very step on thiopurine metabolites,
    the metabolite being detected in the claim. 
    Id. at 78.
    This
    is not at all the case in Athena. The claims are directed to
    a new and useful process of specific, concrete steps for di-
    agnosing MG using a particular immunoassay that had
    never been previously used to diagnose MG. The claims
    should be held patent eligible under § 101 and Mayo.
    I do not believe that the Supreme Court intended Mayo
    to be the sweeping decision it has become. Indeed, it
    warned us that “too broad an interpretation of” its judicial
    22          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    exceptions to eligibility “could eviscerate patent law” be-
    cause “all inventions at some level embody, use, reflect,
    rest upon, or apply laws of nature, natural phenomena, or
    abstract ideas.” 
    Mayo, 566 U.S. at 71
    . I do not understand
    Mayo to render ineligible a claim which covers a specific,
    concrete application of a natural law simply because such
    a claim is diagnostic as opposed to therapeutic. Both
    should be eligible. The last word on this from the Supreme
    Court came in Myriad where the Court made clear “patents
    on new applications of knowledge about BRCA1 and
    BRCA2 genes” could be 
    eligible. 569 U.S. at 596
    . To the
    extent that this Court has read Mayo so broadly that it pre-
    cludes exactly that sort of patent, we have erred. Doing so
    leaves Mayo at odds with the patent statutes and the later
    Myriad decision.
    CONCLUSION
    “It’s important for the judiciary to first recognize that
    there is a problem that needs to be addressed . . . 101 re-
    mains the most important substantive patent law issue in
    the United States today. And it’s not even close.” R. Davis,
    Courts Can Resolve Patent Eligibility Problems, Iancu
    Says, LAW 360 (Apr. 11, 2019) (quoting U.S. Patent and
    Trademark Office Director Iancu). In the wake of Mayo,
    we have painted with a broad brush, suggesting that im-
    proved diagnostic techniques are not patent eligible. Mayo
    did not go so far, and given the import of diagnostic tech-
    niques, we should reconsider this case and clarify our prec-
    edent. Because my colleagues have declined to do so, there
    are no more options at this court for diagnostic patents. My
    colleagues’ refusal deflates the Amici’s hopeful suggestion
    that our precedent leaves the eligibility of a diagnostic
    claim in front of the Federal Circuit “uncertain.” It is no
    longer uncertain. Since Mayo, every diagnostic claim to
    come before this court has been held ineligible. While we
    believe that such claims should be eligible for patent pro-
    tection, the majority of this court has definitively concluded
    that the Supreme Court prevents us from so holding. No
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    need to waste resources with additional en banc requests.
    Your only hope lies with the Supreme Court or Congress. I
    hope that they recognize the importance of these technolo-
    gies, the benefits to society, and the market incentives for
    American business. And, oh yes, that the statute clearly
    permits the eligibility of such inventions and that no judi-
    cially-created exception should have such a vast embrace.
    It is neither a good idea, nor warranted by the statute. I
    dissent.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    NEWMAN, Circuit Judge, with whom WALLACH, Circuit
    Judge, joins, dissenting from denial of the petition for re-
    hearing en banc.
    The majority of the court has voted not to rehear this
    case en banc. I write again in dissent because of the im-
    portance of medical diagnosis and the critical role of the
    patent system in achieving new diagnostic methods. Diag-
    nostic methods are costly in research and development,
    from scientific discovery through federal approval, and are
    of substantial public benefit—exemplified by Athena’s
    2           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    method of diagnosing Myasthenia Gravis in persons previ-
    ously undiagnosable. The patent system provides the eco-
    nomic foundation for the cycle of experimental study,
    clinical evaluation and proof, and implementation in com-
    merce. This foundation applies to diagnosis as well as to
    treatment.
    The panel majority held that the new diagnostic
    method in U.S. Patent No. 7,267,820 (“the ’820 patent”)
    was not eligible for patenting under section 101 of the Pa-
    tent Act. Athena Diagnostics, Inc. v. Mayo Collaborative
    Servs., LLC, 
    915 F.3d 743
    (Fed. Cir. 2019) (Newman, J.,
    dissenting). The panel majority stated that “the Supreme
    Court has effectively told us in Mayo that correlations be-
    tween the presence of a biological material and a disease
    are laws of nature,” and therefore methods for determining
    previously unknown correlations for diagnostic purposes
    are not patent-eligible. 
    Id. at 753
    n.4.
    The majority’s position is a flawed interpretation of the
    Court’s decision in Mayo Collaborative Services v. Prome-
    theus Laboratories, Inc., 
    566 U.S. 66
    (2012). The Court did
    not hold that methods of diagnosis are subject to unique
    patent-eligibility rules. We have mistakenly enlarged the
    Court’s holding, in substance and in application. Rehear-
    ing en banc is warranted.
    I summarize the reasons for concern:
    I
    The Supreme Court’s Mayo decision did not con-
    vert diagnostic methods into laws of nature
    Until Athena’s invention of the diagnostic method de-
    scribed in the ’820 patent, some 20% of patients suffering
    from Myasthenia Gravis were not capable of being diag-
    nosed. The ’820 patent describes and claims a multi-step
    method wherein for such patients the presence in bodily
    fluid of autoantibodies to a protein, muscle-specific tyro-
    sine kinase (MuSK), is detected by “binding of a MuSK or
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    its epitope, together with a revealing label, to the autoan-
    tibodies in the serum or bodily fluid.” ’820 patent, col. 3,
    l. 66–col. 4, l. 2. The ’820 patent explains that “[t]he pre-
    sent inventors surprisingly found that many of the 20% of
    MG patients which do not exhibit any autoantibodies to
    AChR [acetyl choline receptor] instead have IgG [immuno-
    globulin] antibodies directed against the extracellular N-
    terminal domains of MuSK.” 
    Id., col. 1,
    ll. 54–57.
    These antibodies and their reaction with the MuSK
    protein were not known, nor the use of this procedure to
    diagnose Myasthenia Gravis. The separate chemical steps
    of radioactive labelling, reaction of an antibody with a pro-
    tein, separation of the reaction product, and analysis of ra-
    dioactivity, are described in the specification as conducted
    by conventional methods. However, the panel majority
    held that this new diagnostic method is not patent-eligible,
    stating that “claims 7–9 are directed to a natural law be-
    cause the claimed advance was only in the discovery of a
    natural law, and that the additional recited steps only ap-
    ply conventional techniques to detect that natural law.”
    
    Athena, 915 F.3d at 751
    . This statement is a misapplica-
    tion of the patent statute, and a misperception of the
    Court’s decision in Mayo.
    At issue are patent claims 7–9, shown with claim 1
    from which they depend:
    1. A method for diagnosing neurotransmission
    or developmental disorders related to muscle spe-
    cific tyrosine kinase (MuSK) in a mammal compris-
    ing the step of detecting in a bodily fluid of said
    mammal autoantibodies to an epitope of muscle
    specific tyrosine kinase (MuSK).
    7. A method according to claim 1, comprising
    contacting MuSK or an epitope or antigenic de-
    terminant thereof having a suitable label thereon,
    with said bodily fluid,
    4          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    immunoprecipitating any antibody/MuSK com-
    plex or antibody/MuSK epitope or antigenic deter-
    minant complex from said bodily fluid and
    monitoring for said label on any of said anti-
    body/MuSK complex or antibody/MuSK epitope or
    antigen determinant complex,
    wherein the presence of said label is indicative
    of said mammal is suffering from said neurotrans-
    mission or developmental disorder related to mus-
    cle specific tyrosine kinase (MuSK).
    8. A method according to claim 7 wherein said
    label is a radioactive label.
    9. A method according to claim 8 wherein said
    label is 125I [iodine isotope 125].
    The reaction between the specified antibodies and the
    MuSK protein was not previously known, and the specified
    claim steps had not previously been performed, separately
    or in combination. This method of diagnosing Myasthenia
    Gravis and related disorders is conceded to be new and un-
    obvious.
    The ’820 patent specification teaches that each claim
    step is conducted by conventional procedures, that is, pro-
    cedures for creating a radioactively labelled compound, re-
    acting an antibody with a protein, separating any
    antibody-protein complex, and monitoring the radioactiv-
    ity of the product. The panel majority holds that since the
    separate steps are “conventional,” they do not count in the
    section 101 analysis, leaving claims 7–9 with only the gen-
    eral “concept” of “the correlation between the presence of
    naturally-occurring MuSK autoantibodies in bodily fluid
    and MuSK-related neurological diseases like MG.” 
    Athena, 915 F.3d at 750
    . The panel majority concluded that “[t]he
    ’820 patent thus describes the claimed invention princi-
    pally as a discovery of a natural law, not as an
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              5
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    improvement in the underlying immunoassay technology.”
    
    Id. at 751.
         The Court in Mayo admonished against “too broadly
    preempt[ing] the use of a natural 
    law.” 566 U.S. at 72
    .
    Claims 7–9 claim a new multi-step method of diagnosis; it
    is incorrect to omit from the claims the steps by which the
    method is performed, leaving only the “concept” of the gen-
    eral purpose. En banc review is needed to provide con-
    sistent and correct application of statute and precedent to
    methods of medical diagnosis.
    II
    Statute and precedent require that the claimed
    invention is considered as a whole
    The Court explained this principle in KSR Int’l Co. v.
    Teleflex Inc., 
    550 U.S. 398
    (2007):
    [I]nventions in most, if not all, instances rely upon
    building blocks long since uncovered, and claimed
    discoveries almost of necessity will be combinations
    of what, in some sense, is already known.
    
    Id. at 418–19.
    The Court had explored this principle in Di-
    amond v. Diehr, 
    450 U.S. 175
    (1981):
    In determining the eligibility of respondents’
    claimed process for patent protection under § 101,
    their claims must be considered as a whole.
    
    Id. at 188.
    The Court stressed that:
    It is inappropriate to dissect the claims into old and
    new elements and then to ignore the presence of
    the old elements in the analysis.
    
    Id. The Court
    further explained that this rule applies to
    patent eligibility as it does to patentability:
    The “novelty” of any element or steps in a process,
    or even of the process itself, is of no relevance in
    6           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    determining whether the subject matter of a claim
    falls within the § 101 categories of possibly patent-
    able subject matter.
    
    Id. at 188–89;
    see also, e.g., Parker v. Flook, 
    437 U.S. 584
    ,
    594 (1978) (“[A] patent claim must be considered as a
    whole.”); Aro Mfg. Co. v. Convertible Top Replacement Co.,
    
    365 U.S. 336
    , 344 (1961) (“[I]f anything is settled in the pa-
    tent law, it is that the combination patent covers only the
    totality of the elements in the claim and that no element,
    separately viewed, is within the grant.”).
    This established rule does not evaporate when the sub-
    ject matter is a diagnostic method. The Mayo Court did not
    effect such a change. The Court reiterated in Alice Corp.
    Pty. Ltd. v. CLS Bank Int’l, 
    573 U.S. 208
    , 217 (2014), that
    “an invention is not rendered ineligible for patent simply
    because it involves an abstract concept” in some of its claim
    elements. There is no support in the Court’s precedent for
    our abandonment of the invention-as-a-whole in determin-
    ing eligibility under section 101.
    The purpose of section 101 is to provide a broad statu-
    tory scope to inventive activity. See Bilski v. Kappos, 
    561 U.S. 593
    , 605 (2010) (“Section 101 is a dynamic provision
    designed to encompass new and unforeseen inventions.”
    (internal quotation marks omitted)); 
    Diehr, 450 U.S. at 187
    (“[A]n application of a law of nature or mathematical for-
    mula to a known structure or process may well be deserv-
    ing of patent protection.”). In Diamond v. Chakrabarty,
    
    447 U.S. 303
    (1980), the Court observed that “Congress em-
    ployed broad general language in drafting § 101 precisely
    because such inventions are often unforeseeable,” 
    id. at 316,
    and that the legislative history of the 1952 Patent Act
    showed that “Congress intended statutory subject matter
    to ‘include anything under the sun that is made by man,’”
    
    id. at 309
    (quoting S. Rep. No. 1979, 82d Cong., 2d Sess., 5
    (1952); H.R. Rep. No. 1923, 82d Cong., 2d Sess., 6 (1952)).
    The Mayo Court cautioned that
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    too broad an interpretation of this exclusionary
    principle could eviscerate patent law. For all in-
    ventions at some level embody, use, reflect, rest
    upon, or apply laws of nature, natural phenomena,
    or abstract 
    ideas. 566 U.S. at 71
    .
    The Federal Circuit has respected this long-standing
    principle in contexts other than for diagnostic methods.
    See, e.g., McRO, Inc. v. Bandai Namco Games America Inc.,
    
    837 F.3d 1299
    , 1313 (Fed. Cir. 2016) (“[C]ourts must be
    careful to avoid oversimplifying the claims by looking at
    them generally and failing to account for the specific re-
    quirements of the claims.” (internal quotation marks omit-
    ted)). However, we have strayed in our rulings on
    diagnostic methods; our flawed analysis is summarized by
    the majority in 
    Athena, 915 F.3d at 753
    n.4 (“We have since
    confirmed that applying somewhat specific yet conven-
    tional techniques . . . to detect a newly discovered natural
    law does not confer eligibility under § 101.”).
    When viewed on correct law and precedent, Athena’s
    diagnostic method meets the requirements of section 101.
    The appropriate analysis of patentability is under sections
    102, 103, and 112; not section 101.
    III
    The Court in Mayo did not create a section 101
    distinction between diagnostic methods and
    therapeutic methods
    In Mayo the Court discussed the method at issue in
    that case, and concluded that “upholding the patents would
    risk disproportionately tying up the use of the underlying
    natural laws, inhibiting their use in the making of further
    
    discoveries.” 566 U.S. at 73
    . The Court did not hold that
    every diagnostic method ties up a natural law, and the
    Athena panel majority acknowledged that “we agree that
    claim 9 leaves open to the public other ways of
    8          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    interrogating the correlation between MuSK autoantibod-
    ies and MuSK-related disorders without practicing the
    claim’s concrete 
    steps.” 915 F.3d at 752
    .
    Athena’s diagnostic method is not a law of nature; it is
    a novel man-made method of diagnosis of a neurological
    disorder. The Athena diagnostic method, a multi-step
    method performed by a combination of specific chemical
    and biological steps, was unknown in the prior art. The
    Court in Mayo did not exclude such methods from eligibil-
    ity for patenting.
    Following is an outline of this court’s inconsistent rul-
    ings between diagnosis and treatment of disease:
    A. Methods of diagnosis, held ineligible under
    section 101
    1. In re BRCA1- & BRCA2-Based Hereditary Cancer
    Test Patent Litigation, 
    774 F.3d 755
    (Fed. Cir. 2014). The
    claimed invention is a method for screening for genes
    linked to inherited breast and ovarian cancer, by analyzing
    for certain mutations in the DNA. The court held the
    claims ineligible under section 101 as directed to a law of
    nature, and also held that identifying genetic mutations is
    an ineligible abstract idea.
    2. Ariosa Diagnostics, Inc. v. Sequenom, Inc., 
    788 F.3d 1371
    (Fed. Cir. 2015). The claimed invention is a method
    for detecting paternally-inherited fetal abnormalities by
    analyzing the blood or serum of a pregnant female. The
    court held the claims ineligible under section 101, while
    recognizing that “detecting cffDNA in maternal plasma or
    serum that before was discarded as waste material is a pos-
    itive and valuable contribution to science.” 
    Id. at 1380.
        3. Genetic Technologies Ltd. v. Merial L.L.C., 
    818 F.3d 1369
    (Fed. Cir. 2016). The claimed invention is a method
    for detecting a coding region of DNA based on its relation-
    ship to non-coding regions, by amplifying genomic DNA
    with a primer spanning a non-coding sequence in genetic
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              9
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    linkage to an allele to be detected. The court stated that
    “the patent claim focuses on a newly discovered fact about
    human biology,” 
    id. at 1376,
    and that this is a law of nature
    and is ineligible subject matter under section 101.
    4. Cleveland Clinic Foundation v. True Health Diag-
    nostics LLC, 
    859 F.3d 1352
    (Fed. Cir. 2017). The claimed
    invention is a method for diagnosing risk of cardiovascular
    disease by analyzing for the enzyme myeloperoxidase
    (“MPO”). The court held that even though prior methods
    for detecting MPO were inferior, the discovery of how to
    directly analyze for MPO, and discovery of the relation to
    the risk of cardiovascular disease, although “groundbreak-
    ing, ‘even such valuable contributions can fall short of stat-
    utory patentable subject matter.’” 
    Id. at 1363
    (quoting
    
    Ariosa, 788 F.3d at 1380
    ).
    5. Roche Molecular Systems, Inc. v. CEPHEID, 
    905 F.3d 1363
    (Fed. Cir. 2018). The claimed invention is a
    method for detecting the pathogenic bacterium Mycobacte-
    rium tuberculosis (“MTB”), based on nucleotide content
    and a novel method of analysis. The court stated that the
    method is new, unobvious, and “both faster and more accu-
    rate than the traditional MTB detection methods,” 
    id. at 1366,
    but held that the method is ineligible under section
    101.
    6. Cleveland Clinic Foundation v. True Health Diag-
    nostics LLC, 760 F. App’x 1013 (Fed. Cir. 2019). The
    claimed invention is the novel immunoassay to detect the
    correlation between blood MPO levels and cardiovascular
    disease. The court held that the claims are for a law of
    nature and ineligible under section 101.
    In all of these diagnostic cases the claims were held in-
    eligible under section 101, whether or not the method of
    diagnosis was new and unobvious, and independent of pa-
    tentability under sections 102, 103, and 112.
    10          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
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    B. Methods of treatment, held eligible under
    section 101
    1. Rapid Litigation Management Ltd. v. CellzDirect,
    Inc., 
    827 F.3d 1042
    (Fed. Cir. 2016). The claimed invention
    is a “method of producing a desired preparation of multi-
    cryopreserved hepatocytes [liver cells].” 
    Id. at 1047.
    The
    court stated that “the natural ability of the subject matter
    to undergo the process does not make the claim ‘directed to’
    that natural ability,” 
    id. at 1049
    (emphasis omitted), and
    “[t]his type of constructive process, carried out by an arti-
    san to achieve ‘a new and useful end,’ is precisely the type
    of claim that is eligible for patenting,” 
    id. at 1048
    (quoting
    
    Alice, 573 U.S. at 217
    ).
    2. Vanda Pharmaceuticals Inc. v. West-Ward Pharma-
    ceuticals Int’l Ltd., 
    887 F.3d 1117
    (Fed. Cir. 2018). The
    claimed invention is a method of treating schizophrenia
    with the known drug iloperidone, where the dose is ad-
    justed based on whether the patient is a “CYP2D6 poor me-
    tabolizer.” 
    Id. at 1121.
    The method uses genetic testing to
    determine CYP2D6 metabolism. The court held that this
    is “a specific method of treatment for specific patients using
    a specific compound at specific doses to achieve a specific
    outcome,” 
    id. at 1136,
    and is eligible under section 101.
    3. Natural Alternatives Int’l, Inc. v. Creative Com-
    pounds, LLC, 
    918 F.3d 1338
    (Fed. Cir. 2019). The claimed
    invention is a method of increasing athletic performance by
    administering beta-alanine in larger quantities. The court
    held the method eligible under section 101, although the
    mechanism was a natural effect.
    4. Endo Pharmaceuticals Inc. v. Teva Pharmaceuticals
    USA, Inc., 
    919 F.3d 1347
    (Fed. Cir. 2019). The claimed in-
    vention is a method of treating patients with oxymorphone,
    based on the discovery that patients with impaired kidney
    function need less oxymorphone for pain relief. The court
    stated that the method was patent-eligible, for “the claims
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            11
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    here are directed to a treatment method, not a detection
    method.” 
    Id. at 1356
    (emphasis in original).
    IV
    The amici curiae advise on the consequences of
    our rulings 1
    The major biotech industry organizations advise that
    our court’s application of Mayo “has caused great uncer-
    tainty to the industry, and . . . has called into doubt innu-
    merable biotech patents.”         Biotechnology Innovation
    Organization (BIO) Br. at 3. BIO discusses the incon-
    sistency of our section 101 rulings, and points out that
    “[t]he panel decision reflects a troubling divergence in this
    court’s section 101 jurisprudence between software and bi-
    otech inventions,” explaining that in software cases the
    threshold analysis focuses on whether the claims contain a
    technical improvement over the prior art, whereas this as-
    pect is absent from our biotech analyses. 
    Id. at 9.
         The amici discuss the adverse effect of our section 101
    rulings on advances in medical diagnosis. Seven Law Pro-
    fessors state that “diagnostic tests form[] the basis of 60%–
    70% of all medical treatment decisions,” and “[d]iagnostic
    tests have immense benefits for patient care and greatly
    reduce associated costs, including decreasing hospitaliza-
    tion and avoiding unnecessary treatment.” Profs. Br. at 11
    (citing The Value of Diagnostics Innovation, Adoption and
    Diffusion into Health Care (July 2005), available at
    1   Amicus curiae briefs were filed by the Biotechnol-
    ogy Innovation Organization, Pharmaceutical Research
    and Manufacturers of America, Croplife International,
    Wisconsin Alumni Research Foundation, Seven Law Pro-
    fessors, and Freenome Holdings Inc. and Achillion Phar-
    maceuticals, Inc.
    12         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    https://dx.advamed.org/sites/dx.advamed.org/files/resource/
    Lewin%20Value%20of%20Diagnostics%20Report.pdf).
    The Law Professors state that “[t]he economics of the
    R&D and commercialization of innovative diagnostic tests
    reflect the core economic justification for the patent sys-
    tem: The marginal cost of making a diagnostic test is rela-
    tively low, but the ex ante R&D costs can be enormous,”
    stating that the cost of commercializing a diagnostic test is
    between $50-$100 million. 
    Id. at 11–12
    (citing Diaceutics
    Group, Mystery Solved! What is the Cost to Develop and
    Launch a Diagnostic? (2013), available at https://www.di-
    aceutics.com/?expert-insight=mystery-solved-what-is-the-
    cost-to-develop-and-launch-a-diagnostic). The Law Profes-
    sors state that by “creat[ing] an unduly restrictive patent
    eligibility doctrine under § 101, the majority decision and
    many other court decisions send the wrong message to in-
    novators that groundbreaking diagnostic tests born of the
    biotechnological arts in the modern biopharmaceutical in-
    dustry are virtually per se unpatentable under § 101.” 
    Id. at 13.
        Amici curiae Freenome Holdings and Achillion Phar-
    maceuticals suggest that our jurisprudence contravenes
    “promot[ing] the Progress of Science and useful Arts.” U.S.
    Const. art. I, § 8, cl. 8. These amici point to the judicial
    duty to construe section 101 to include both inventions and
    discoveries, and that discovery of a new diagnostic method
    is within the constitutional purpose.
    I repeat that “the public interest is poorly served by
    adding disincentive to the development of new diagnostic
    methods. This is a severe criticism; and when presented
    by the entire industry, and stressed by thoughtful scholars,
    it warrants judicial attention.” 
    Athena, 915 F.3d at 762
    (Newman, J., dissenting).
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE            13
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    The need for en banc action
    The judicial responsibility is to provide clear and con-
    sistent law in conformity with statute. Our holdings on
    medical diagnostics contravene the admonition that courts
    “should not read into the patent laws limitations and con-
    ditions which the legislature has not expressed.”
    
    Chakrabarty, 447 U.S. at 308
    .
    The legislative plan is for an incentive system that sup-
    ports advances in useful technologies by enabling innova-
    tors to benefit economically. The patent statute requires
    that the new knowledge is disclosed to the public, where it
    adds to the body of knowledge and, in turn, may be studied
    and built upon. No benefit has been suggested by exclud-
    ing medical diagnostic methods from the patent incentive
    system.
    This case presents an opportunity for judicial review
    and judicial remedy. Although diagnostic methods are not
    the only area in which section 101 jurisprudence warrants
    attention, Federal Circuit precedent is ripe for reconsider-
    ation specific to diagnostic methods, to correct our applica-
    tion of the Mayo decision and to restore the necessary
    economic incentive. As summarized by Senators Chris
    Coons and Thom Tillis, co-chairs of the Senate Subcommit-
    tee that is conducting hearings on proposed remedial legis-
    lation, “courts have clouded the line to exclude critical
    medical advances like life-saving precision medicine and
    diagnostics,” and “studies showed that investors familiar
    with the current lack of clarity invest less in critical re-
    search and development in areas like medical diagnostics.”
    The Senators stated that “[e]ven some witnesses advocat-
    ing against broad reform conceded that there are problems
    with the current system, particularly in the life sciences.”
    Report available at https://www.law360.com/articles/1171672/
    what-coons-and-tillis-learned-at-patent-reform-hearings
    (June 21, 2019).
    14         ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    From my colleagues’ denial of en banc review, I respect-
    fully dissent.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    STOLL, Circuit Judge, with whom WALLACH, Circuit
    Judge, joins, dissenting from the denial of the petition for
    rehearing en banc.
    In a series of cases since the Supreme Court’s decision
    in Mayo Collaborative Services v. Prometheus Laboratories,
    Inc., 
    566 U.S. 66
    (2012), we have established a bright-line
    rule of ineligibility for all diagnostic claims. See, e.g., Ari-
    osa Diagnostics, Inc. v. Sequenom, Inc., 
    788 F.3d 1371
    ,
    1377 (Fed. Cir. 2015) (rejecting a diagnostic claim because
    the “only subject matter new and useful as of the date of
    2           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    the application was the discovery of the presence of cffDNA
    in maternal plasma or serum”). This rule as applied to the
    facts of this case dictated that the majority panel find the
    claimed invention ineligible. But, because this court’s
    bright-line rule is based on an over-reaching and flawed
    test for eligibility, a test that undermines the constitu-
    tional rationale for having a patent system—promoting the
    progress of science and useful arts—the court should take
    this opportunity to correct its erroneous rule. So, while I
    stand by the panel decision in this case, I write separately
    to dissent from the denial of en banc rehearing because the
    question of the eligibility of diagnostic inventions is exactly
    the type of exceptionally important issue that warrants full
    consideration by this court.
    Federal Rule of Appellate Procedure 35 directs us to
    order rehearing en banc when “the proceeding involves a
    question of exceptional importance.”           Fed. R. App. P.
    35(a)(2). A question is of exceptional importance if it cre-
    ates “important systemic consequences for the develop-
    ment of the law and the administration of justice.” Watson
    v. Geren, 
    587 F.3d 156
    , 160 (2d Cir. 2009). As Judge New-
    man and Judge Moore aptly describe, a wholesale bar on
    patent eligibility for diagnostic claims has far-reaching and
    long-ranging implications for the development of life-sav-
    ing diagnostic methods. The eligibility of life-saving inven-
    tions is not only one of the most important issues of patent
    law, but of human health. Thus, the importance of the is-
    sue here mandates that we consider it en banc.
    Interpreting Mayo, our prior opinions seem to take for
    granted that the Supreme Court has foreclosed all avenues
    of patent protection for diagnostic claims. As Judge Moore
    points out, we have held every diagnostic claim in every
    case before us ineligible. Dissent Op. at 2 (Moore, J.). Our
    inflexible following of Mayo has created flawed decisions
    that are inconsistent with the precepts of Mayo and our pa-
    tent system as a whole. The Mayo test was guided by
    broad-sweeping principles that are not applicable to every
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE                 3
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    individual diagnostic claim. For example, Mayo empha-
    sizes that patent eligibility cannot apply to “processes that
    too broadly preempt the use of a natural 
    law.” 566 U.S. at 72
    . Certain diagnostic claims, such as the ones at issue in
    this case, are so narrowly tailored that preemption is not a
    reasonable concern.
    Given the importance of this question, I would urge the
    en banc court to take the opportunity to entertain the
    thoughtful argument and fully developed record that such
    review would provide, and reconsider this critically im-
    portant issue. As Congress’s recent interest in § 101 legis-
    lation has demonstrated, there are a variety of
    stakeholders that consider this issue to be vitally im-
    portant. En banc rehearing would not only permit us to
    have a more extensive view of the various considerations
    underlying Mayo, but it would also allow us to create judi-
    cial doctrine geared toward the practical application of
    Mayo’s principles. At the very least, en banc review would
    help the court develop an articulable standard for its § 101
    jurisprudence moving forward.
    In my view, by consistently bypassing en banc review
    of a critical issue that goes to the heart of this court’s juris-
    diction, we are abdicating our responsibility. For this rea-
    son, I respectfully dissent.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ATHENA DIAGNOSTICS, INC., OXFORD
    UNIVERSITY INNOVATION LTD., MAX-PLANCK-
    GESELLSCHAFT ZUR FORDERUNG DER
    WISSENSCHAFTEN E.V.,
    Plaintiffs-Appellants
    v.
    MAYO COLLABORATIVE SERVICES, LLC, DBA
    MAYO MEDICAL LABORATORIES, MAYO CLINIC,
    Defendants-Appellees
    ______________________
    2017-2508
    ______________________
    Appeal from the United States District Court for the
    District of Massachusetts in No. 1:15-cv-40075-IT, Judge
    Indira Talwani.
    ______________________
    O’MALLEY, Circuit Judge, dissenting from the denial of the
    petition for rehearing en banc.
    I agree with all aspects of Judge Moore’s thoughtful
    dissent. Indeed, I agree with all my dissenting colleagues
    that our precedent applies the Supreme Court’s holding in
    Mayo Collaborative Services v. Prometheus Laboratories,
    Inc., 
    566 U.S. 66
    (2012) too broadly. I write separately,
    however, because I believe that confusion and disagree-
    ments over patent eligibility have been engendered by the
    2          ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    fact that the Supreme Court has ignored Congress’s direc-
    tion to the courts to apply 35 U.S.C. sections 101, et seq
    (“Patent Act”) as written. Specifically, the Supreme Court
    has instructed federal courts to read into Section 101 an
    “inventive concept” requirement—a baffling standard that
    Congress removed when it amended the Patent Act in
    1952. I encourage Congress to amend the Patent Act once
    more to clarify that it meant what it said in 1952.
    I begin with some historical perspective. After World
    War II, federal courts were invalidating patents at break-
    neck speed. Lawrence Baum, The Federal Courts and Pa-
    tent Validity: An Analysis of the Record, 56 J. Patent Office
    Soc’y 758, 760 tbl. 1 (1974) (showing that federal appellate
    courts, on average, invalidated patents at a rate of 77% be-
    tween 1941–1945), 777 tbl. 5 (showing that the Supreme
    Court invalidated patents at a rate higher than 81% from
    1921–1973, except during 1953–1964 when the Court did
    not issue any decisions on patent validity). As Justice
    Jackson wrote, it seemed the only valid patent was “one
    which [the Supreme Court] ha[d] not been able to get its
    hands on.” Jungersen v. Ostby & Barton Co., 
    335 U.S. 560
    ,
    572 (1949) (Jackson, J., dissenting). This was due, in large
    part, to what became known as the “invention require-
    ment”—itself “invented” by the Supreme Court rather than
    Congress or the Constitution. Applying this requirement
    meant asking whether a patent evidenced “invention.”
    Prominent jurists of that time remarked that the re-
    quirement was unworkable. Judge Learned Hand opined
    that, under this requirement, “‘invention’ became perhaps
    the most baffling concept in the whole catalogue of judicial
    efforts to provide postulates for indefinitely varying occa-
    sions.” Lyon v. Bausch & Lomb Optical Co., 
    224 F.2d 530
    ,
    536 (2d Cir. 1955). According to Judge Giles Rich, because
    inventiveness “is an unmeasurable quantity having differ-
    ent meanings for different persons,” the invention require-
    ment “left every judge practically scott-free to decide this
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              3
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    often controlling factor according to his personal philoso-
    phy of what inventions should be patented.” Giles S. Rich,
    The Vague Concept of Invention as Replaced by Sec. 103 of
    the 1952 Patent Act, 46 J. Patent Office Soc’y 855, 865
    (1964) (internal quotations and citations omitted). If the
    invention requirement and its criticisms sound familiar,
    that is because they are.
    Congress attempted to address these criticisms by
    amending the Patent Act to replace the ill-defined and ju-
    dicially-created invention requirement with the more
    workable anticipation and obviousness tests codified in
    Sections 102 and 103. Patent Act of 1952, Pub. L. No. 82-
    593, § 103, 66 Stat. 792, 798 (1952); see, e.g., H.R. 4061,
    80th Cong. (1947) (as introduced to the H. Comm. on the
    Judiciary, July 1, 1947) (“A BILL To establish a criterion
    of invention with respect to patent applications and issued
    patents[.]”); Nat’l Patent Planning Comm’n, The American
    Patent System, June 18, 1943, H.R. Doc. 78-239, at 10
    (“One of the greatest technical weaknesses of the patent
    system is the lack of a definitive yardstick as to what is
    invention.”); 
    id. at 5
    (“The most serious weakness in the
    present patent system is the lack of a uniform test or stand-
    ard for determining whether the particular contribution of
    an inventor merits the award of the patent grant. . . . The
    difficulty in applying this statute arises out of the presence
    of the words ‘invented’ and ‘discovered.’ Novelty alone is
    not sufficient, nor is utility, nor is the final accomplish-
    ment. There must also be present some mysterious ingre-
    dient connoted in the term ‘invented.’”).
    But although Congress so amended the Act decades
    ago, we continue to apply the invention requirement today
    under a new name—the “inventive concept” requirement.
    Early cases applying § 101 after the 1952 amendment,
    such as Parker v. Flook, 
    437 U.S. 584
    (1978), drew heavily
    from cases decided under the “invention” requirement.
    Compare Funk Bros. Seed Co. v. Kalo Inoculant Co., 
    333 U.S. 127
    , 131 (1948) (concluding that the “aggregation of
    4           ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE
    SERVICES
    species” at issue “fell short of invention” because “[i]f there
    is to be invention from such a discovery, it must come from
    the application of the law of nature to a new and useful
    end”), with 
    Flook, 437 U.S. at 591
    (“Mackay Radio and
    Funk Bros. point to the proper analysis for this case.”).
    Flook therefore forged a two-part test, with respect to
    § 101, that is seemingly indistinguishable from the one
    that had been applied in many “invention” cases over
    twenty-five years earlier. First, Flook treated the natural
    law as part of “the prior art.” 
    Flook, 437 U.S. at 594
    . Sec-
    ond, Flook asked whether what remained—apart from the
    prior art, i.e. the natural law—constituted “invention.” 
    Id. (“Respondent’s process
    is unpatentable under § 101, not be-
    cause it contains a mathematical algorithm as one compo-
    nent, but because once that algorithm is assumed to be
    within the prior art, the application, considered as a whole,
    contains no patentable invention.”); see also Diamond v.
    Diehr, 
    450 U.S. 175
    , 204 (1981) (“Under this procedure, the
    algorithm is treated for § 101 purposes as though it were a
    familiar part of the prior art; the claim is then examined to
    determine whether it discloses ‘some other inventive con-
    cept.’”) (quoting 
    Flook, 437 U.S. at 594
    )). Against this back-
    drop, the search for an inventive concept—now enshrined
    in the § 101 inquiry via Mayo—calls back to the invention
    requirement that Congress quite deliberately abrogated
    through the Patent Act of 1952.
    In fact, the disagreement here centers on whether the
    additional limitations in the claims, either individually or
    as an ordered combination, satisfy the inventive concept
    requirement. Compare Lourie Op. at 4 (“Under Supreme
    Court precedent, I do not believe that specific yet purely
    conventional detection steps impart eligibility to a claim
    that otherwise only sets forth what the Court has held is a
    natural law.” (internal quotations omitted)), with Moore
    Op. at 20 (“These [additional] steps are not set out at the
    ‘high level of generality’ that concerned the Court in Mayo,
    ATHENA DIAGNOSTICS, INC. v. MAYO COLLABORATIVE              5
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    and they specifically confine their reach to a specific appli-
    cation of the relationship between anti-MuSK antibodies
    and MG.”). Had the Supreme Court not disregarded Con-
    gress’s wishes for a second time, perhaps the outcome in
    this case would be different. See Lourie Op. at 2 (“If I could
    write on a clean slate, . . . I would not exclude uses or de-
    tection of natural laws.”). Indeed, claims directed to uses
    of natural laws rather than the natural laws themselves
    would be eligible under § 101 as written. Because the Su-
    preme Court judicially revived the invention requirement
    and continues to apply it despite express abrogation, I dis-
    sent to encourage Congress to clarify that there should be
    no such requirement read into § 101; to clarify that con-
    cepts of novelty and “invention” are to be assessed via ap-
    plication of other provisions of the Patent Act Congress
    designed for that purpose.