ASA Joins National Coalition Urging Improved NSA Enforcement and Accountability

The American Society of Anesthesiologists (ASA), in partnership with a coalition of leading physician and healthcare organizations, is urging federal agencies to strengthen enforcement of the No Surprises Act (NSA), the landmark law designed to protect patients from unexpected medical bills. In a joint letter to the Departments of Treasury, Labor, and Health and Human Services, ASA and its partners emphasized that while the law has made meaningful progress in shielding patients from financial harm, gaps in insurer compliance and oversight threaten its effectiveness. 

ASA has played a leading role in advocating for balanced implementation of the NSA—ensuring that patients are protected while also safeguarding the ability of anesthesiologists and other frontline physicians to deliver care and receive appropriate payment for that care. Specifically, ASA continues to champion the law’s Independent Dispute Resolution (IDR) process as a critical safeguard for resolving payment disputes between anesthesiologists and insurers.

In the formal request to the federal agencies, ASA and the coalition highlight growing concerns about insurer practices that undermine the intent of the law. These include a lack of good-faith engagement during required open-negotiation period and reliance on inaccurate payment benchmarks.  /Data cited in the letter shows that while the vast majority of claims are resolved without arbitration, insurers frequently fail to meaningfully participate in negotiations, forcing clinicians to pursue the IDR process to secure appropriate payment. 

ASA is also advocating for greater transparency and accountability across the system. The coalition calls for improved disclosure of critical insurance information, stronger enforcement mechanisms, and support for legislation such as the No Surprises Act Enforcement Act, which would hold insurers accountable for non-compliance and delayed payments to those anesthesiologists who prevail in the IDR process. These reforms, ASA argues, are essential to reducing administrative burdens on physician practices and ensuring the law functions as intended.

As implementation of the NSA continues to evolve, ASA remains committed to working with policymakers and stakeholders to strengthen the law. By advancing solutions that protect patients while ensuring anesthesiologists are fairly compensated, ASA is helping to preserve access to high-quality care and uphold the integrity of the healthcare system.