In 2023, ASCA tracked more than 650 bills across the 50 states for potential impacts on ASCs. Certain trends from past years continued, like the focus on surgical smoke evacuation requirements and state-level price transparency requirements. New, disturbing trends also arose, including facility fee prohibition proposals across the country. Certain major changes occurred around certificate of need (CON) laws in the south at the same time as many states are scrutinizing noncompete clauses in healthcare employment contracts.