The perspective by Joseph Impicciche (Modern Healthcare September 2024) of Ascension hits home for me as an advocate for healthcare of more than 25 years.  In those two and half decades, I have actively worked on legislation and rulemaking for healthcare entities, professionals and patients. It was not uncommon for specifics to be worked out through the rulemaking process. Whether one might believe this process is right or wrong, the reality is Loper Bright now requires Congress to have a clearer intent and more specifics in their legislative language. This will require an early voice in the process to not only ensure your agenda is advanced but of equal importance that legislative language does not negatively impact you. As the saying goes--If you are not at the table, you might be on the menu.