ASA has learned that BlueCross BlueShield of North Carolina is sending letters to anesthesia and other physician practices threatening contract termination unless providers agree to immediate rate reductions from 5% to 35%. The letters suggest that the insurer is using this tactic to improve their negotiation position against providers in the flawed independent dispute resolution (IDR) process outlined in the interim rule of the No Surprises Act. ASA opposes the current IDR process and is working with other stakeholders to change the proposed regulation to permit a fairer process.