Lawsuit seeks to end AMA's control over medical billing codes, challenging a key revenue stream and access barrier in healthcare administration
Executive summary: PatientRightsAdvocate.org (PRA) filed a lawsuit against the American Medical Association (AMA) on August 13, 2026, seeking to invalidate the AMA's copyright over CPT medical billing codes and make them freely available to the public. CPT codes are required by law for medical billing in the U.S., but the AMA currently licenses them, generating significant revenue; removing this barrier could reduce administrative costs and increase pricing transparency across healthcare.
Who is involved: PatientRightsAdvocate.org (plaintiff), American Medical Association (defendant), with potential impacts on healthcare providers, insurers, patients, and government health programs.
Likely next: The AMA will likely file a motion to dismiss or defend its copyright claims; the case may proceed to discovery and could take months or years to resolve, depending on jurisdictional rulings.
PatientRightsAdvocate.org has filed a federal lawsuit against the American Medical Association (AMA) alleging that the AMA's copyright over Current Procedural Terminology (CPT) codes unlawfully restricts public access to codes required by federal and state law for medical billing. The suit argues that patients, providers, and health plans should not be forced to pay a private trade association to use codes mandated for insurance claims and government programs. If successful, the case could disrupt the AMA's licensing revenue model and increase transparency in healthcare pricing and billing practices.
Timeline
- — PatientRightsAdvocate.org Sues American Medical Association to Make Medical Billing Codes Freely Available to the Public (PR Newswire)
Analysis — what this means
Likely next events
- AMA expected to respond to lawsuit within 21 days (by early September 2026)
- Potential court hearing on preliminary injunction request by PRA in Q4 2026
- If case proceeds, discovery phase may begin in early 2027
Sectors affected
- Healthcare administration
- Medical billing software
- Health information technology (HIT)
- Revenue cycle management (RCM)
Regulatory implications
- Could prompt HHS or CMS to reevaluate CPT code accessibility under existing federal mandates
- May strengthen arguments for adopting open alternatives like LOINC or SNOMED CT in public programs
Historical parallels
- Similar to 2008 Oregon Medical Board case where CPT copyright was challenged but settled without ruling on validity
- Analogous to disputes over copyright in legal codes (e.g., Georgia v. Public.Resource.Org, 2020) where courts restricted claiming copyright on law
- Parallels 2010s efforts to challenge AMA's CPT monopoly via federal rulemaking, which did not succeed