The Advocacy page provides resources and tools to ensure that patients' needs and wishes are taken seriously and their best interests are put first. Advocates must be skilled go-betweens, educators, troubleshooters, negotiators, and proactively vocal in tricky situations. In the role of patient advocate, the healthcare team must walk a fine line between paternalism and interest protection. Respecting patients as partners, and promoting their perspective is an essential part of advocacy (Mitchell & Bournes, 2000).

1. Insurance-related Resources
   The NMSS Director of Federal Health Affairs & Insurance Policy, Kim Calder has shared the following resources:
   
   • Expertise in the implications of the Affordable Care Act (healthcare reform) for people with MS - presentations and educational materials in different formats are available including several (customizable) PowerPoint presentations on the key issues for people with MS in the ACA; a dedicated website section highlighting Frequently Asked Questions (http://www.nationalmssociety.org/government-affairs-and-advocacy/affordable-care-act-resources/index.aspx) and carefully vetted resources; plus the National MS Society’s “Principles for Healthcare Reform.”
   • Expertise in general health insurance topics to help people with MS, caregivers, volunteers, etc. make best use of their health coverage (private, Medicare, Medicaid, or combos) and avoid pitfalls. A dedicated National MS Society web page titled, Insurance and Money Matters can be accessed at http://www.nationalmssociety.org/living-with-multiple-sclerosis/insurance-and-money-matters/index.aspx
   • Health Insurance Resources: A Guide for People with Chronic Disease and Disability, 2nd ed. – Northrop, Cooper, Calder, Demos Medical Publishing, 2003. (The Society cannot offer free copies of this, but are aware that Demos provides a small discount to those who purchase it through their IRC.)
   • Health Insurance Appeal Letters Toolkit for Clinicians and expertise on filing effective appeals (click here)
   • Manuals on Social Security Disability Insurance for people with MS, and clinicians, as well as comparable information for those seeking private disability insurance benefits. All of these are available online (http://www.nationalmssociety.org/living-with-multiple-sclerosis/insurance-and-money-matters/other-insurance/index.aspx), and will need updating to reflect new information about quick reviews for certain SSDI applicants.
   • Referral list of attorneys specializing in health and disability law to whom clients may be referred. These are often provided for clients facing challenges by their private disability insurance plans, and the list is organized around location of the attorneys; practices and licensing.
2. Joint Select Committee on Deficit Reduction:
   Well, the ‘supercommittee’ threw out the white flag a day early. On November 22, one day before their deadline, the Committee announced that it couldn’t come to an agreement on a debt reduction package as called for in the Budget Control Act that passed this summer. Later this week our ‘Federal Focus’ will be sent out with more detail on what this all means, but in a nutshell, with no package there is no December 23 vote on the package which means that ‘sequestration’ will occur with the 2013 federal budget unless Congress and the president agree to alter that provision of the Budget Control Act. Click here for more info on sequestration.
3. SuperCommittee failure – fallout for future Medicare beneficiaries:
   No one knows for sure what all the fallout will be from the SuperCommittee failure but here is a summary of news reports on what it might mean for future Medicare beneficiaries.
4. Federal Activism Council:
   The Federal Activism Council met on November 11 to discuss submissions and in a slight departure from the past, we provided an in depth overview of all the issues our office is working on including past Public Policy Conference priorities along with the myriad of issues relevant to people with MS. Four issues were presented to the group as possible new priorities including Telemedicine, the high cost of MS drugs, increasing the amount a person can earn while on SSDI, and two ideas that would help employment and business opportunities for people with disabilities. We are working on follow-up with these and will communicate further about the issues in the future.
5. ROY/SOY/GOY:
   Just a pre-reminder about the Representative, Governor, and Senator of the Year submissions. Our office needs them by December 14 so we can do appropriate review, etc.
6. Medical Loss Ratio (MLR):
   Part of the Affordable Care Act mandated that a certain percentage of health care premiums be spent on patient care, not administrative or other costs. That has caused quite a stir among insurance brokers and some others. The National Association of Insurance Commissioners (NAIC) has been in the thick of the debate and you can learn more here.
7. Health Reform and the Supreme Court:
   As you know, the U.S. Supreme Court is taking up the health reform law to determine the constitutionality of the individual mandate among other things including the legality of Medicaid expansion – here is a good blog post on that aspect. Another interesting article highlighted Democratic fears that the Obama Administration will lose in the Supreme Court – click here.
8. Health Reform Q & A:
   Kaiser Health posted this video about whether an adult child who is no longer in school can still have health care coverage from her parents.
9. Health Reform Implementation Timeline:
   Here is another good timeline showing how the Affordable Care Act implementation plays out over the coming years (assuming it all moves ahead of course).
10. MS International Federation Petition:
    Hopefully you all already received the action alert about the online petition asking employers and decision makers to remove the barriers that prevent people with MS from finding and staying in work – if you haven’t signed the petition yet, you can do so at petition.
11. Alphabet Soup: Forms of Disability Coverage and What you Need to Know
    by Jamie R. Hall, Esquire
    Employment issues – from filling out forms to verifying information needed for insurance coverage, financial payments and benefits – challenge and sometimes frustrate health care providers and staff. Lifestyle decisions can impact the entire family and often hinge on the counsel and support of medical providers. To meet the continuing need for information about disability coverage, lawyer, Jamie Hall provides an overview of the types of disability.
    (Click here to view PDF)
12. Social Security Disability and MS: The Impact of the MS Listing
    by Jamie R. Hall, Esquire
    (Click here to view PDF)
13. Social Security Disability: A Primer
    by Jamie R. Hall, Esquire
    (Click here to view PDF)
14. The New Americans with Disabilities Act is Here!
    by Peter Fischer
    (Click here)
15. Advocacy in Multiple Sclerosis
    A White Paper prepared by CMSC
    (Click here to view PDF)