53 msfocusmagazine.org that is rejected by your plan, you may have to take another drug which may not be as effective for your particular case. This could result in a relapse, which might not have occurred if you were on the original treatment prescribed by your doctor. This is an issue MS Focus has been involved in for several years. Commercial insurance companies have been allowed to impose step therapy.We’vewritten letters on behalf of those with MS to state insurance commissioners and to insurance companies asking them to allow individuals to have the medication prescribed forthem bytheirphysician,without having to fail any other medications first. However this is the first time that those on Medicare plans would face them. MS Focus has joined a coalition of many disease-related nonprofit organizations and physician associations in signing a letter that urges the Centers for Medicare and Medicaid Services to reconsider this policy. Those with chronic illnesses should not have to run the risk of increased disease activity before they are eligible to take a preferred drug for their condition. Another possible change to Medicare and Medicaid would require billing for physician evaluation and management of patients (office visits) to be paid at the same rate for all physicians regardless of the complexity of the services they provide. This would result in a cut in reimbursement for specialists such as MS neurologists. MS Focus and other members of the MS Coalition signed a letter to CMS at the request of the American Academy of Neurology. We believe that this would have a negative effect on the care of those with MS because some physicians would have to spend less time with their patients during office visits, resulting in the need for additional visits to address complex symptoms. Not only would this increase time and travel for those with MS, but it would also cost them more in out-of-pocket expenses for copayments for the extra visits. The AAN is concerned that such a plan would create an even greater shortage of neurologists than there already is, by discouraging physicians fromgoingintofieldsthatrequirecomplexcare. I had the opportunity to meet directly with the staff for Florida’s congressional delegation and senators during my visit in July. They were open to hearing about how these and other proposed changes could affect the MS community. I implored them to take the voice of those affected by chronic diseases into consideration when voting on issues that directly affect them. You can depend on MS Focus to continue working behind the scenes and to keep you informed. Jeri Francoeur, Disha Banik and MS Focus Director Natalie Blake at Florida Senator Bill Nelson’s office. Tell us what you want to see in MS Focus Magazine. Email comments to: editor@msfocus.org or write to: Editor, MS Focus 6520 N. Andrews Ave., Fort Lauderdale, FL 33309