Late in the evening on March 2, the Senate voted 78-19 to pass H.R. 4691, the "Temporary Extension Act of 2010," which included provisions to extend 2009 Medicare physician payment rates through the end of the month. As a result, the 21% payment cut that took effect on March 1 has been postponed until April 1.

The bill passed the House on February 25, only to encounter opposition on the Senate floor by Senator Jim Bunning (R-KY), who objected to the legislation being considered as an emergency measure that would not require budgetary offsets. In addition to postponing Medicare physician payment cuts, the bill extended a variety of other expiring programs including unemployment insurance and premium subsidies for COBRA continuation coverage for those whose employment was involuntarily terminated.

Discussions are still underway in the House and Senate on the next steps that will be taken to address the Medicare payment crisis. Proposals are being circulated that would implement still another short-term patch to the sustainable growth rate (SGR) formula, including proposals that would postpone cuts for 90 days, 7 months, or through the end of 2010. The AMA continues to press for permanent repeal of the SGR, rather than repeating the pattern of short-term remedies that serve to make future payment cuts more severe and increase the cost of permanent Medicare payment reform.

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