Dr. Mueller addressed how the ASA is dividing the major economic issues, which include the 33% Medicare problem, possible Medicare for All legislation, surprise medical bills, and value-based payment models, across the ASA committees. Dr. Pregler presented the progress on the 33% problem with a review of the three publications that the workgroup has produced over the last year (available at ASAHQ.org/payment). He also presented the current strategy of the ASA to develop additional arguments that support increasing the Medicare anesthesia conversion factor. The ASA is also evaluating possible modifications to the ASA RVG payment system that would support improved valuation or at least containment of the problem. The ASA is currently in the RFP process to obtain outside technical consultant support to perform the analytic work for both strategies. Dr. Cohen presented an in-depth look at the ASA's initiatives to prepare for any possible Medicare for All legislation and an analysis of all the current legislative proposals. Dr. Champeau concluded the program with an excellent review of the federal No Surprises Act. He reviewed how the current rulemaking process bypassed the intent of the congressional legislation and put increased importance in the Qualifying Payment Amount. This unfairly favors the commercial payors in the arbitration process, which could ultimately affect commercial contracting. With all the challenges we face, there has never been a more critical time for all anesthesiologists to come together and speak as one voice! Annual Publication 2021 | 13http://ASAHQ.org/payment