Lott Wants End to AMA Copyright on Medicare Billing Codes

Senate Minority Leader Trent Lott (R-Miss.) has asked HHS to end the American Medical Association's "monopoly" on Medicare and Medicaid billing codes, a system that he said has prevented patients from "shopping for medical care based on price" and "hampered efforts to reduce fraud," the Washington Times reports. The federal government established the Medicare billing system in 1983 and allowed the AMA to have exclusive use and copyright of the current procedural terminology codes for reimbursing Medicare and Medicaid outpatient services. According to Lott, the AMA receives $71 million in annual royalties and book sales through the copyright, and by "aggressively guarding" the copyright in court, "the AMA has also been able to control who uses the codes and who knows what about the cost of doctor services." Through the copyright, the group "has been able to impose on the entire nation the AMA's obviously self-interested policy against consumers comparison shopping for medical care," Lott said, adding, "Comparison shopping and proper billing to avoid mistakes and fraud are two of the most potent weapons we have to combat the routine double-digit increases in health care costs that keep millions of Americans uninsured." For its part, the AMA has said that patients should not select doctors based on billing comparisons. In a letter to HHS Secretary Tommy Thompson, Lott asked the agency to develop a universal coding system "for all of the federal government's health information needs," as well as determine how much the federal government and private insurers could save from a universal code system and how much the AMA has received in royalties, book sales and other revenue since 1983 from the CPT code copyright. Lott sent the letter just days after the House passed patients' rights legislation (HR 2563) supported by President Bush and many Republicans (Boyer, Washington Times, 8/7).