October 28, 1999

After a period of playing possum, the "Collections of Information Antipiracy Bill" (H.R. 354) is back. Republican leaders in the House leadership is pushing for the bill to go to the floor. The AMA is apparently working behind the scenes for this bill, as shown by the House Report that accompanies it (pertinent pages of the report will be posted at www.aapsonline.org under Legislation, Collections of Information Antipiracy Act.)

The reason: easy electronic dissemination of information threatens the AMA's lucrative monopoly on the CPT codes that doctors are forced to use.

In the House Report, the emphasis is on the millions of dollars that the AMA invests in the "organization and maintenance of the CPT codes" - not on the millions of dollars in profits that it rakes in from selling the codes to physicians.

"In 1983," states the report, "the AMA granted the Health Care Financing Administration a royalty free license to use CPT in its Medicare, Medicaid and related programs." Imagine that: "Our AMA," with the power to make generous "grants" to the government!

"When government agencies publish the CPT medical code, they make it clear that extraction and redistribution of the information is subject to the terms and conditions established by the AMA...." Because it would cost the government so much to collect a similar data base, "a general public good is served by the arrangement between AMA and government," claims the Report.

In other words, the AMA wants to preserve its ability to charge for the codes, despite the fact that the CPT is needed to "fulfill a government obligation as established in law or regulation."

CPT is key: to the AMA's profitability, but also to the stranglehold that the "public- private partnership" is gradually establishing over the practice of medicine. From a simple system in 1991, CPT or medicine-by-the-numbers has become a monstrosity. Deviate from the AMA-HCFA "guidelines" -which are so vague and arbitrary that violations can be found anywhere-and you could be fined, delicensed, and even imprisoned.

The AMA is attempting to use this law to circumvent a court decision (Practice Management Info. Corp. v. AMA) which determined that the AMA was misusing its copyright.

Call as many House members as possible. Tell them to OPPOSE H.R. 354. The proposed substitute (H.R. 1858) is much better if they must support something.

The Capitol switchboard is (202) 225-3121.