Capsule Summary of the Association of American Physicians and Surgeons (AAPS)

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 Website: www.aapsonline.org

Cause/goals/mission

  • Preserve and promote the practice of private medicine
  • Defend the constitutional rights of patients and physicians

The Association of American Physicians and Surgeons – AAPS – is a non-partisan professional association of physicians in all types of practices and specialties across the country. Since 1943, AAPS has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. Our motto, “omnia pro aegroto” means “all for the patient.”

Size and reach

All specialties; all forms of practice; nationwide; members in every state

Prominent members have included the late Francis Davis, long-time editor of Private Practice; the late Edward Annis, former AMA president; a number of elected or appointed officials; and a president of the Texas Medical Association and of the Medical Society of the State of New York.

Accomplishments

On the legislative front

  • Defeated Wagner-Murray-Dingell bill in the 1940s (AMA takes credit, but was doing nothing until AAPS was founded and took up this cause).
  • Testified against Medicare and predicted the outcomes we have seen.
  • Helped the enactment of the bill enabling physicians to officially opt out of Medicare
  • Helped to stop HillaryCare (the Clinton Health Security Health Security Act) with our lawsuit (see below); obtained and exposed many documents of the Clinton Task Force on Health Care Reform
  • Had marathon “Read the Bill” sessions in D.C. and participated in rallies nationwide opposing ObamaCare
  • Supporting efforts to repeal statutory and regulatory “safe harbors” for PBM and GPO kickbacks
  • Working to remove harmful features of bill allowing HSA funds to pay Direct Primary Care memberships
  • Proposed and helped enact medical board reforms in Texas
  • Successfully fought against making MOC a condition of licensure and for bills preventing exclusion of doctors for not doing MOC; helped enact anti-MOC legislation in Texas (2017), which was then enacted in Tennessee (2018), and also helped enact anti-MOC legislation in Oklahoma (2016) and Kentucky (2016)

Lawsuits

  • Ass’n of Am. Physicians & Surgeons v. Weinberger, 395 F. Supp. 125 (N.D. Ill. 1975), sued to challenge the constitutionality of the federal Professional Standards Review law that created Professional Standards Review Organizations (PSRO).
  • Whitney v. Heckler (1984), brought by AAPS members, Atlanta surgeons Douglass Whitney, M.D., and W. Daniel Jordan, M.D., sued to challenge the constitutionality of a “two-year” freeze on Medicare physician fees.
  • Stewart v. Sullivan (1992), lawsuit brought by AAPS Past President Lois Copeland and some of her patients to try to establish the right to privately contract on a case-by-case basis outside the Medicare system.
  • AAPS v. Clinton (1993) sued to challenge the secrecy of Hillary Clinton’s task force composition and meetings, and this lawsuit helped stop HillaryCare.
  • AAPS v. U.S. FDA, 226 F. Supp. 2d 204 (D.D.C. 2002) successfully sued to overturn a regulation by the FDA.
  • AAPS v. HHS (2002) sued to establish the “country doctor exemption” from HIPAA overregulation, freeing third-party-free physicians who do not transmit information related to “covered transactions” electronically.
  • AAPS v. Texas Medical Board (2007) sued to challenge wrongdoing by the Texas Medical Board, and to hold them legally accountable for constitutional violations. This is the only known case to have put a medical board on trial, in 2012 in federal court in Austin.  After our lawsuit was filed, the legislature then banned anonymous complaints against physicians, and also required that complaints by insurance companies be fully disclosed to physicians, which caused the number of those complaints to drop precipitously.
  • AAPS was the only physician group to directly challenge the PPACA by bringing lawsuits in court, in AAPS v. Sebelius and AAPS v. Koskinen. AAPS has filed more than 10 amicus briefs in support of other challenges.
  • AAPS v. ABMS (2013) sued to challenge ABMS on antitrust grounds (still ongoing after much delay).
  • AAPS v. Rouillard, Director of the California Department of Managed Health Care (2017) sued to challenge California AB 72, which gives insurers the power to impose fee limits of only 125% of Medicare on out-of-network physicians.

Sampling of amicus briefs against sham peer review

Mileikowsky, M.D. v. Tenet Health Systems et al., Supreme Court of the United States No. 05-638 (December 2005); Springer v. Henry, 435 F.3d 268 (3d Cir. 2006) (establishing a landmark precedent against retaliation against a physician who had exercised his First Amendment right to criticize management, including an award of punitive damages to him): Untracht, M.D. v. Fikri, M.D. et al., United States Court of Appeals for the Third Circuit – Case No. 3:03 CV 199 (Dec 2006); Lawnwood Regional Med Ctr. v. Seeger, M.D. et al., First District Court of Appeal, State of Florida, Case No.: 1D06-2016 (12-22-06) and Supreme Court of Florida (12/10/2007); Misischia, D.M.D. v. St. John’s Mercy Health Systems et al., Supreme Court of the United States No. 06-623 (01/05/2007); Cowett, M.D. v. TCH Pediatrics, Inc. et al., Supreme Court of the United States No. 06-1593 (06-29-07); Poliner, M.D. v. Texas Health Systems et al., United States Court of Appeals, 5th District, Case No.: 06-11235 (10-11-07); Also, U.S. Supreme Court No. 08-543, 11/21/2008 ; Cole, M.D., vs. St. James Healthcare, Montana Second Judicial District Court, Silver Bow County, Cause No. DV-07-44 (11-09-07); Wahi, M.D. vs. Charleston Area Medical Center et al., U.S. District Court of Appeals, 4th Circuit, (03-11-08); Also, U.S. Supreme Court No. 09-430 (11/12/2009); Peyton v. Johnson City Med. Ctr., No. E2001-02477-COA-R3-CV (Ct. App. Tenn., 2002); Bhanusali v. Orange Regional Medical Center et al., No. 13-3426-cv, Ct of Appeals, 2nd Cir. 12-23-2013; Valfer v. Evanston Nw. Healthcare, 52 N.E.3d 319 (Ill. Sup. Ct. 2016); Villare v. Beebe Med. Ctr., Inc., 108 A.3d 1226 (Del. 2015); Shenoy v. Charlotte-Mecklenburg Hosp. Auth., 521 F. App’x 168 (4th Cir. 2013); United States v. Zadeh, 820 F.3d 746 (5th Cir. 2016); Desai v. Lawnwood Med. Ctr., Inc., 219 So. 3d 869 (Fla. Dist. Ct. App. 2017); Van Boven v. Lakeway Regional Medical Center (Texas Dist. Ct. 2018).

Sampling of amicus briefs related to other issues

United States v. Rutgard, 116 F.3d 1270 (9th Cir. 1997) (helped overturn key portions of the conviction of an exemplary physician who was then able to do mission trips and perform more eye surgeries for the poor in foreign countries than anyone else); Veeck v. S. Bldg. Code Cong. Int’l, 293 F.3d 791 (5th Cir. 2002) (established a precedent against monopoly private standards that are imposed by law, such as the AMA’s CPT coding system); United States v. Natale, 719 F.3d 719 (7th Cir. 2013) (opposing the criminalization of mistakes in a physician’s own dictated operating notes); Sissel v. United States HHS, 760 F.3d 1 (2014) (seeking to overturn ObamaCare based on the Origination Clause); Michigan Catholic Conference v. Burwell, 135 S. Ct. 1914 (2015); Priests for Life v. HHS, 136 S. Ct. 446 (2015) (on a petition for cert. to the U.S. Supreme Court, in opposition to the contraceptive mandate in ObamaCare); Little Sisters of the Poor Home for the Aged v. Burwell, 799 F.3d 1315 (10th Cir. 2015) (same, also in opposition to an ObamaCare regulation); Bryant v. King, 138 S. Ct. 314 (2017) (on a petition for cert. to the U.S. Supreme Court, in support of the protections of arbitration clauses by physicians). 

Other activities

  • Testimony in state legislatures in person or in writing (e.g. in Texas, Arizona, Louisiana, and New Jersey on medical licensure board issues; in Indiana against maintenance of certification requirements)
  • Congressional testimony
  • Congressional briefings
  • Letters to Congress
  • Action alerts on state and national issues
  • Legislative updates (now curated by Dr. Marilyn Singleton)
  • News round-ups (now curated by Dr. Jane Orient)
  • Monthly newsletter since the 1940s
  • Quarterly peer-reviewed journal, now in volume 23 (jpands.org)
  • Op-eds, about 36 per year, in a wide variety of publications. Members of the op-ed team have been published in the Wall Street Journal, Investor’s Business Daily, the Washington Times, Townhall, WND, and Newsmax. After each article, writers do radio interviews on national and local shows and are frequently quoted in Breitbart, Medscape, and other outlets.
  • News releases, about 50 per year. They are picked up in hundreds of publications and have made the top of the Drudge Report.
  • Common Sense Medicine by Jeff Danby, a concise primer on medical economics. We have distributed thousands of copies.
  • Commissioned review of the financial status of the “Billion Dollar Swamp Creature” (ABMS and member boards) by CPA Charles Kroll, and also Arizona’s 100% managed-care Medicaid system.
  • Annual meeting, with CME credit, and regional Thrive Not Just Survive Workshops (latest was the 27th, also with CME, to help physicians maintain independence in many types of
  • Comments on regulatory issues, including very extensive analysis on MACRA by Dr. Held.

Resources

Contact

(800) 635-1196; [email protected]

Structure

501(c)(6)
Member-supported

Leadership (2017-2018)

President: Albert L. Fisher, M.D., Oshkosh, W; President-elect: Marilyn M. Singleton, M.D., J.D., Redondo Beach, CA; Secretary: Charles W. McDowell, Jr., M.D., Johns Creek, GA; Treasurer: W. Daniel Jordan, M.D. Atlanta, GA; Immediate Past President: Michael J.A. Robb, M.D., Phoenix, AZ; Directors include MACRA expert Kristin Held, M.D., San Antonio, TX and MOC expert Paul Martin Kempen, M.D., Ph.D., Weirton, WV, Sham Peer Review expert, Lawrence Huntoon, M.D., Ph.D, Lake View, NY.

Executive Director: Jane M. Orient, M.D.: [email protected]

General Counsel: Andrew Schlafly, J.D.

Chair of Committee to Combat Sham Peer Review: Lawrence Huntoon, MD, JD

Business manager, webmaster, director of regulatory affairs: Jeremy Snavely: [email protected]

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