WHEREAS , in 1997 the Ninth U.S. Circuit Court of Appeals held in Practice Management Information Corporation v. the American Medical Association (121 F.3d 516 [9th Cir. 1997]) that the AMA exclusivity agreement with HCFA for using CPT® gave the AMA a substantial and unfair advantage over its competitors and constituted a misuse of the copyright by the AMA, and WHEREAS , subsequent to this case the AMA and HCFA eliminated the exclusivity clause in their agreement, and WHEREAS , as part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Department of Health and Human Services designated CPT® and HCPCS as the national standards for electronic transaction of healthcare information, and WHEREAS , the contract between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) for the use of CPT® codes remains outlined in a licensing agreement which authorizes CMS to use CPT® codes for Medicare, Medicaid, and other CMS-administered programs, and WHEREAS , CMS advises physicians to use CPT® codes (level 1 of HCPCS) to code physician services, including evaluation and management services, and WHEREAS , any individual or entity using CPT® content needs permission or a license (i.e., an end-user agreement, end user license agreement, or other written agreement authorizing use of CPT® codes) from the AMA or an authorized distributor, Therefore, be it RESOLVED , that it is the policy of the Louisiana State Medical Society that the Healthcare Common Procedure Coding System (HCPCS) Level I codes which are part of the Current Procedural Terminology (CPT®) code set should be maintained in an open-source fashion by the Centers for Medicare & Medicaid Services (CMS) and be it further RESOLVED that it is the policy of the Louisiana State Medical Society that code sets mandated for use in Claims Processing and Payment under the authority of the Centers for Medicare & Medicaid Services (CMS) should be made available by CMS without royalty, license, or per-use fees payable by physicians, providers, and patients, and be it further RESOLVED , that the Louisiana State Medical Society shall notify members of the Louisiana Congressional delegation of policies adopted concerning the open-source status of, and the elimination of fees regarding use of, any and all code sets mandated for use in Claims Processing and Payment under the authority of the Centers for Medicare & Medicaid Services (CMS).
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