On behalf of millions of members, supporters, and activists across America, the undersigned organizations collectively write to share our concerns about the implementation of the No Surprises Act (NSA). The NSA went into effect on January 1, 2022. The law established a national framework for resolving out-of-network billing disputes between insurers and providers that ensures patients are not forced to pay out-of-pocket costs beyond their in-network responsibility. In short, the NSA was passed to protect patients from surprise medical bills.