On Thursday afternoon, the House of Representatives passed the legislation necessary to prevent the 21% SGR cut from taking place on Monday.  The House bill would extend for 30 days the SGR deadline.
 
Unfortunately, last night, the Senate was unsuccessful in its attempt to pass legislation extending the SGR deadline. 
 
The House and Senate are attempting to move a package of other expiring provisions along with the SGR extender, including unemployment insurance and COBRA protections for the unemployed.  When the Senate Leadership requested Unanimous Consent to bring up the House passed bill up for a vote, Senator Jim Bunning (R-KY) objected.  Senator Bunning continued to object throughout the night and at Midnight, the Senate adjourned for the night.   Bunning's objection is that the "extenders" package is not paid for and, according to the Congressional Budget Office would add approximately $10 Billion dollars to the national debt.  Bunning has proposed using unspent money from the stimulus bill to pay for these extensions.
 
At this point, the only thing preventing the "extenders" bill from going to the President is Bunning's objection.  It is my understanding that no other Senator has objected.  Bunning has said that he will continue to object to moving the bill until the legislation is "paid for". 
 
Although it is possible that overnight Senator Bunning will have an epiphany and withdraw his objections today, there were no indications that this would be the case.  
 
Physicians should be prepared for the 21% reduction to take effect on Monday as scheduled. 
 
It is still conceivable that the cuts will not be realized in that Medicare holds claims for 14 days technically giving the Senate some additional time to resolve the problem.  I realize - and I believe the Congress realizes - that resolving this impasse after Sunday (the 28th) creates a situation where the provider will be collecting coinsurance on one amount (the amount with the 21% reduction) only to have the money restored prior to the actual claim payment. 
 
We will continue to monitor this and report any news as quickly as possible.