'FT: RFK, Jr. Plans Attack on AMA’s Big Meal Ticket, Licensing Fees for Medical Billing Codes'

 The Financial Times has a new story on one of RFK, Jr.s’ plans, should he be approved as director of the Department of Health and Human Services. He is threatening to end Medicare and presumably also Medicaid’s use of the current medical billing code system, which goes by the acronym CPT, with a new system. The reason for proposing a change is that the AMA charges hefty licensing fees. From the Financial Times:

Reforms to the CPT codes would also represent an existential threat to the AMA, which generates more than half of its $495mn annual revenues from its CPT work and other royalties payments. A person close to the lobbying group said reforms of Medicare’s billing system could unleash as much chaos as the hack of UnitedHealth’s Change Healthcare division, which affected 100mn patients and roiled healthcare providers for months.

And there is no long-term contract in force to obligate Medicare to keep using the CPT codes:

Medicare has no obligation to accept the proposals of the AMA committee, which meets three times a year to update physicians’ billing codes, but it typically accepts the proposals.

Mind you, RFK, Jr. isn’t wrong to see these licensing fees as a form of grifting. From the Financial Times comment section:

Progressive Patriot

The article talks about CPT (Current Procedural Terminology) codes that were developed by the American Medical Association (AMA) and are used within the US and around 60 countries internationally.

https://en.wikipedia.org/wiki/Current_Procedural_Terminology

One of the issues here is the “licensing fee” that the AMA receives just for someone using their coding system which, by all reasonable accounts, should be in the public domain. It is just a categorization system that has been amended countless times since its inception, maybe in the 1960’s or so.

It would be akin to having to pay to use the Dewey Decimal System or the Library of Congress Classification system.

And it may well be (or turn out in the end) that RFK, Jr. taking this issue to the press means he’ll seek to bargain the rates down instead.1 Perhaps RFK, Jr. is mainly interested in defunding or defanging the AMA, which has consistently and forcefully opposed single payer. But RFK, Jr. isn’t a supporter either:

https://www.nakedcapitalism.com/2024/11/rfk-jr-plans-attack-on-amas-big-meal-ticket-licensing-fees-for-medical-billing-codes.html