<p> EXAMPLE LETTER FOR PATIENTS TO SIGN</p><p>Date</p><p>The Honorable Barack Obama United States Senate Washington, DC 20510</p><p>Dear Senator Obama,</p><p>I write to you as a concerned patient regarding the proposed changes to the Ambulatory Surgery Center (ASC) payment system currently under review by the Centers for Medicare and Medicaid Services. I believe the proposed rule will have a negative effect on the procedures used frequently by physicians practicing interventional pain management (IPM) and likewise patients such as me.</p><p>I sincerely hope that you can see the enormity of this issue and act to protect patient access to interventional pain management services across the country. Your colleagues, Sen. Sherrod Brown (D-OH) and David Vitter(R-LA) jointly sent a letter to CMS asking them to adjust the payments in a budget neutral fashion to eliminate the cuts and keep the access to interventional pain management services.</p><p>I respectfully request you to join this bipartisan effort in maintaining patient access to interventional pain management services by also sending a letter to CMS to preserve patient access.</p><p>Sincerely,</p><p>______Signature</p><p>______Printed name</p><p>______Address</p><p>______City, State Zip</p>