IP Law Daily, COPYRIGHT NEWS: American Hospital Association sues to block publication of medical billing codes, (Dec 15, 2025)

By Jonathan Anderson

The defendant, a healthcare advocacy organization, argued that a manual containing the codes cannot be copyrighted because it is incorporated by reference into law.

The American Hospital Association filed a lawsuit against a healthcare advocacy organization seeking to enjoin it from publishing a manual containing medical billing codes. The suit advanced three claims against PRA: copyright infringement, breach of contract, and anticipatory breach of contract. The defendant, PatientRightsAdvocate.org, had expressed its intent to post the manual online, arguing that it is not copyrightable and that even if it was subject to copyright, publishing the manual on the internet would constitute fair use (American Hospital Association v. PatientRightsAdvocate.org, Inc., No. 1:25-cv-15137 (N.D. Ill. filed Dec. 12, 2025)).

Background. On Dec. 12, 2025, the American Hospital Association and its subsidiary, Health Forum LLC (AHA), filed a lawsuit seeking to block healthcare advocacy organization PatientRightsAdvocate.org (PRA) from posting online a manual containing medical billing codes. The complaint, filed in the Northern District of Illinois, Eastern Division, advanced three claims against PRA: copyright infringement, breach of contract, and anticipatory breach of contract.

In a letter to AHA in November 2025, PRA disclosed that it had obtained a copy of the Official UB-40 Data Specifications Manual, 2026 Edition, and intended to make the document freely available on the internet to the public at large. The manual contains unified billing codes for medical procedures that hospitals and other providers use throughout the country to streamline the billing process. AHA sells licenses to annual versions of the manual. PRA asked AHA to confirm that it would not take any legal action against it for posting the document, and that if AHA failed to provide such an assurance, PRA would consider litigation to confirm its legal rights.

PRA argument. PRA argued that it should be allowed to share the manual publicly because the federal government and at least 30 states require hospitals to use the manual to obtain reimbursement for medical treatments. PRA further argued that the manual is not copyrightable because at least six states have incorporated the manual into regulations that carry the force of law. PRA also argued that at the very least, the fair use doctrine permits PRA to make the manual available to the public.

AHA argument. In its complaint, AHA argued that its creative efforts to produce the manual are precisely the kind of work that copyright laws were intended to protect. AHA argued that it obtained federally registered copyrights for the manual and related works, and that purchasers of the manual must expressly agree not to distribute any part of it to third parties and not to challenge the AHA’s intellectual property rights. AHA further argued that a privately authored work’s copyright protection does not disappear merely because the government refers to that work or requires consultation of it.

Copyright infringement. Count one of the complaint alleged copyright infringement under 17 U.S.C. § 501. AHA said it anticipated that PRA or its agents have made unauthorized copies of the manual in preparation for the planned posting of the document or in preparation for litigation.

Breach of contract. Count two of the complaint alleged breach of the confidentiality provisions of the AHA’s license agreement for the manual. The agreement required a purchaser of the manual to agree not to share it or its contents, create derivative works, or copy content except with limited exceptions.

Anticipatory breach of contract. Count three of the complaint alleged anticipatory breach of AHA’s no-contest provision of the licensing agreement. Under the agreement, a purchaser of the manual must agree not to challenge AHA’s proprietary rights to the manual or its content.

Relief sought. AHA sought an award of any profits earned by PRA and any actual damages suffered because of the alleged infringement, or alternatively maximum statutory damages; an award of damages for breach of the license agreement; an injunction to enjoin PRA from publishing to third parties all or parts of the manual; a declaration that PRA’s publication of the manual would violate the Copyright Act and the license agreement; a declaration that any attempts by PRA to challenge the manual’s copyright protection would violate the licensing agreement; and reasonable attorneys’ fees and court costs.

The Case is No. 1:25-cv-15137.

Judge: Pacold, M.

Attorneys: Elizabeth P. Papez (Gibson, Dunn & Crutcher LLP) for American Hospital Association and Health Forum LLC.

Companies: American Hospital Association and Health Forum LLC; PatientRightsAdvocate.Org, Inc.

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