Editor’s note: This is the first part of a two-part column. Look for the second part in the January 2021 Regulatory Review.

On February 27, 2020, ASCA staff advocated for payment policy changes with senior level executives with the Centers for Medicare & Medicaid Services (CMS) at the US Department of Health & Human Services (HHS) offices in Washington, DC. Just two months into the new year, this ended up being our last “routine” meeting for 2020—the last one that did not center around the 2019 novel coronavirus (COVID-19). While COVID-19 had been declared a public health emergency by HHS Secretary Alex Azar on January 31, the last week of February was when federal efforts became more public, as a task force was announced from HHS headquarters the same day we were there. Two weeks later, President Donald Trump declared a national state of emergency, and ASCA’s efforts accelerated rapidly to advocate for the role that ASCs could play during the public health emergency (PHE) and the resources needed to allow our facilities to continue to provide high-quality and safe outpatient surgery during the PHE and beyond.