{"id":2639271,"date":"2026-08-02T14:06:02","date_gmt":"2026-08-02T18:06:02","guid":{"rendered":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/trump-admin-putting-major-medical-associations-billing-code-monopoly-under-the-microscope\/"},"modified":"2026-08-02T14:11:15","modified_gmt":"2026-08-02T18:11:15","slug":"trump-admin-putting-major-medical-associations-billing-code-monopoly-under-the-microscope","status":"publish","type":"post","link":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/trump-admin-putting-major-medical-associations-billing-code-monopoly-under-the-microscope\/","title":{"rendered":"Trump Admin Putting Major Medical Association&#8217;s Billing Code &#8216;Monopoly&#8217; Under The Microscope"},"content":{"rendered":"<aside class=\"mashsb-container mashsb-main mashsb-stretched\"><div class=\"mashsb-box\"><div class=\"mashsb-count mash-medium\" style=\"&quot;\"><div class=\"counts mashsbcount\">24<\/div><span class=\"mashsb-sharetext\">SHARES<\/span><\/div><div class=\"mashsb-buttons\"><a class=\"mashicon-facebook mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/www.facebook.com\/sharer.php?u=https%3A%2F%2Fwww.conservativenewsdaily.net%2Fbreaking-news%2Ftrump-admin-putting-major-medical-associations-billing-code-monopoly-under-the-microscope%2F\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Facebook<\/span><\/a><a class=\"mashicon-twitter mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/twitter.com\/intent\/tweet?text=&amp;url=https:\/\/www.conservativenewsdaily.net\/breaking-news\/?p=2639271&amp;via=ConservNewsDly\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Twitter<\/span><\/a><a class=\"mashicon-subscribe mash-medium mash-nomargin mashsb-noshadow\" href=\"#\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Subscribe<\/span><\/a><div class=\"onoffswitch2 mash-medium mashsb-noshadow\" style=\"display:none\"><\/div><\/div>\n            <\/div>\n                <div style=\"clear:both\"><\/div><\/aside>\n            <!-- Share buttons by mashshare.net - Version: 4.0.47--><p>The article discusses the US government&#8217;s scrutiny of the American Medical Association (AMA) regarding it&#8217;s influence over medical billing codes, specifically the Current Procedural terminology (CPT) codes. These codes,created to standardize medical procedure documentation,are controlled exclusively by the AMA,which generates notable revenue from licensing them. Critics, including Republicans like rep. Diana Harshbarger and Sen. Bill Cassidy, argue that this monopoly leads to higher healthcare costs, stifles competition, and benefits the AMA financially through licensing fees. The Centers for Medicare and Medicaid Services (CMS) has proposed a rule inviting public comment on the potential harms of the AMA\u2019s dominant role. Concerns also extend to the AMA\u2019s political activities and its promotion of <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/american-health-care-providers-offer-treatment-based-on-race\/\" title=\"American ... Providers Offer Treatment Based On Race\">health equity initiatives<\/a>. Critics describe the AMA\u2019s model as regulatory capture, highlighting issues of monopoly power, conflicts of interest, and the lack of competition in healthcare coding systems.  <\/p>\n<p class=\"readmore\">\n    <button onclick=\"showReadMore()\" id=\"readmorebtn\">Read more&#8230;<\/button>\n<\/p>\n<hr id=\"line\">\n<span id=\"more\"><br \/>\n<!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\"><br \/>\n<?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><?xml encoding=\"utf-8\" ?><html><body><\/p>\n<section> \t\t\t\t<script>console.log(\"ad slot (AC1)\")<\/script><script>console.log(\"ad slot (IC1)\")<\/script><script>console.log(\"ad slot (IC2)\")<\/script><script>console.log(\"ad slot (IC3)\")<\/script><script>console.log(\"ad slot (IC4)\")<\/script><script>console.log(\"ad slot (REP_0)\")<\/script><\/p>\n<p>The Trump administration is now scrutinizing the American Medical Association over the \u201cinfluence\u201d its medical billing codes have on healthcare nationwide.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Current Procedural Terminology (CPT) codes are meant to \u201cprovide a uniform nomenclature for coding medical procedures and services,\u201d <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.ama-assn.org\/topics\/cpt-codes\"><u><span class=\"LexicalEditorTheme__textUnderline\">according<\/span><\/u><\/a>  to the AMA. However, some <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/washingtonreporter.news\/exclusive-rep-diana-harshbarger-wants-increased-ama-transparency-on-cpt-billing-codes\/\" target=\"_blank\" rel=\"noopener\">Republicans<\/a> have <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.healthcaredive.com\/news\/CPT-codes-2026-american-medical-association\/759929\/\" target=\"_blank\" rel=\"noopener\">raised<\/a> concerns about whether the AMA currently holds too much sway over the medical care coding system, which could potentially stifle competition and drive up health costs.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">The Centers for Medicare and Medicaid Services <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/public-inspection.federalregister.gov\/2026-14327.pdf\"><u><span class=\"LexicalEditorTheme__textUnderline\">issued<\/span><\/u><\/a>  a proposed <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.federalregister.gov\/documents\/2026\/07\/16\/2026-14327\/medicare-and-medicaid-programs-cy-2027-payment-policies-under-the-physician-fee-schedule-and-other\" target=\"_blank\" rel=\"noopener\">rule<\/a> on July 16 that includes a request for public comment \u201con a number of areas regarding the influence of the CPT coding system and AMA process on physician payment policy as part of the Secretarial priority to Make America Healthy Again.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cWhat, if any, evidence is there for CMS to consider regarding the harms or challenges associated with AMA\u2019s monopoly over CPT-4 licenses for health care entities?\u201d the proposed rule asks.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">CMS notes in the proposed rule that there has been \u201clongstanding concern expressed over the Federal reliance on a private organization with such an obvious conflict of interest as providing information on the time and resource requirements to conduct physician services when this information may influence their own payment.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">CMS also claims that the \u201chistoric reliance on the CPT and[RVSUpdateCommittee([RVSUpdateCommittee(<a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.ama-assn.org\/about\/rvs-update-committee-ruc\" target=\"_blank\" rel=\"noopener\">RUC<\/a>)]process as a potential contributor to the development of US health care as a \u2018sick care\u2018 system with limited emphasis on prevention and lifestyle modifications and which may inhibit progress on the Secretarial priority to Make America Healthy Again.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">The AMA did not respond to the Daily Caller News Foundation\u2019s request for comment.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cAs a pharmacist for more than 30 years, I\u2019ve seen how government-protected monopolies can drive up costs, stifle innovation, and ultimately leave patients paying the price,\u201d Republican Tennessee Rep. Diana Harshbarger told the DCNF in a statement.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cThe Current Procedural Terminology (CPT) code set has become essential healthcare infrastructure, yet it remains controlled by a single private organization that faces no meaningful competition. When one organization controls the coding system used throughout Medicare and much of the entire healthcare system, that\u2019s a problem.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cCongress should bring transparency, competition, and accountability to this process so providers, innovators, and patients all benefit from a more open and competitive system,\u201d Harshbarger continued.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">CPT codes refer to medical services and procedures performed by physicians and other qualified healthcare professionals, <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\"><u><span class=\"LexicalEditorTheme__textUnderline\">according<\/span><\/u><\/a>  to the AMA. The organization also notes that CPT codes can \u201cenable physicians, providers, payers, regulators, vendors and health care technology organizations to document, communicate and understand the care provided to patients.\u201d<\/p>\n<div>The AMA currently possesses \u201cthe power to force\u201d healthcare insurers and government agencies to rely on its CPT codes, according to the Institute for Legislative Analysis\u2019 Center for Healthcare Affordability executive director Fred McGrath.<\/div>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cThe AMA\u2019s model is a textbook case of regulatory capture,\u201d McGrath told the DCNF. \u201cThe Health Insurance Portability and Accountability Act of 1996 effectively gave the AMA, a private entity, the power to force healthcare insurers, providers, suppliers, and government entities to use its codes. As one would expect when an organization is granted monopoly power, the AMA has used that position to generate more than $500 million in annual revenue.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cWhile this may not be among the largest drivers of healthcare costs, the monopoly profits being generated affect the bottom lines of healthcare organizations and unnecessarily increase costs,\u201d he added. \u201cThe greater concern is that the AMA is a highly politicized entity that has pledged to \u2018infuse racial equity and social justice into the fabric of AMA\u2019s culture, systems, policies, and practices.\u2019\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Another major criticism of the AMA is the money the medical organization generates from <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/compliance.ama-assn.org\/hc\/en-us\/articles\/12578083609623-Accessing-AMA-Content-Files-in-the-Royalties-Portal-for-Internal-Use-Licensees\" target=\"_blank\" rel=\"noopener\">licensing<\/a> the CPT codes.<\/p>\n<div>Republican Louisiana Sen. Bill Cassidy wrote in an October 2025 <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.help.senate.gov\/imo\/media\/doc\/cassidy_letter_to_ama_on_cpt_monopoly.pdf\"><u><span class=\"LexicalEditorTheme__textUnderline\">letter<\/span><\/u><\/a>  to the AMA that he felt \u201cparticularly offended\u201d about the organization \u201cabusing its government-endorsed CPT monopoly to charge every stakeholder in the health care system significant amounts of money while advancing an anti-patient agenda.\u201d<\/div>\n<p class=\"LexicalEditorTheme__paragraph\">Cassidy also alleged that the AMA \u201chas abused this government-backed monopoly by charging exorbitant fees to anyone using the CPT code set, including doctors, hospitals, health plans, and health IT vendors.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">\u201cMore than half of that revenue came from the publication of books and digital content, including the annual publication of CPT codes that are used to code for medical procedures and services. CPT codes are required to be used by providers to bill for services, and the AMA has had an exclusive monopoly on publishing these codes for over 40 years.\u201d<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Cassidy\u2019s office did not respond to the DCNF\u2019s request for comment.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">In 2024, the AMA <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.ama-assn.org\/system\/files\/2024-ama-annual-report.pdf\"><u><span class=\"LexicalEditorTheme__textUnderline\">disclosed<\/span><\/u><\/a>  that it had notched $513.2 million in total annual revenue, up from $495.1 million in 2023. The AMA\u2019s total revenue from royalties surged from $65.8 million to $284.8 million from 2011 to 2023, STAT News <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.statnews.com\/2025\/06\/13\/american-medical-association-lobbying-cpt-billing-codes-cme\/\" target=\"_blank\" rel=\"noopener\">reported<\/a>.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Though, it remains unclear exactly how much of the AMA\u2019s annual revenue stems from CPT code licensing.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Additionally, the AMA has previously <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.ama-assn.org\/about\/leadership\/ama-s-2024-2025-strategic-plan-advance-health-equity\"><u><span class=\"LexicalEditorTheme__textUnderline\">promoted<\/span><\/u><\/a>  embedding \u201cracial justice\u201d and advancing \u201chealth equity\u201d in the U.S. healthcare system.<\/p>\n<p class=\"LexicalEditorTheme__paragraph\">Multiple anonymous AMA doctors <a class=\"LexicalEditorTheme__link\" href=\"https:\/\/www.politico.com\/news\/2026\/06\/10\/ama-doctors-physicians-rfk-vaccines-00957489\"><u><span class=\"LexicalEditorTheme__textUnderline\">told<\/span><\/u><\/a>  Politico in June that the organization has become increasingly agitated with Health and Human Services Secretary Robert F. 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