On December 6, the Academy joined 20 other surgical specialties in submitting coalition comments on the most recent No Surprises Act regulations. The joint comments register significant concerns with the interim final rule as written. The regulation establishes the median in-network rate as the default factor considered in the independent dispute resolution process. This could incentivize payers to set artificially low payment rates, creating more narrow provider networks and reducing access to care. The rules are scheduled to take effect on January 1. The Academy will continue advocating with federal agencies and Congress to ensure protections for patients and providers that are consistent with Congressional intent in passing the No Surprises Act.