The federal No Surprises Act (NSA), implemented in 2022, represents an important step forward in protecting patients from surprise medical bills and improving transparency within the health care system. Unfortunately, the NSA's flawed implementation has revealed significant problems for physicians seeking to navigate the law to secure appropriate payments. The challenges posed for anesthesiologists across the country confirm the society's longstanding concerns that the implementing regulations could benefit insurance companies to the detriment of anesthesiology practices of all sizes.

The law's implementation has been imbalanced, benefiting payers while creating financial challenges for anesthesiology practices, especially small and medium-sized community-based practices. Some practices operating with the most fragile economics may not be able to remain in business much longer. That's why ASA is working on multiple fronts to advocate for changes to protect anesthesiologists and their practices.

Although the challenges come in various shapes and sizes, it boils down to the...

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