The countdown begins again. Only two weeks remain until a 21% pay cut for Medicare physicians takes effect, and lawmakers once again are debating between a temporary and a permanent fix to the problem.

Physicians who treat Medicare patients will on June 1 see a 21% reduction in their reimbursement rates. The cuts were scheduled to take place twice this year, but temporary holds on claims processing from the Centers for Medicare & Medicaid Services effectively stopped them.

Rather than enact another temporary fix, some lawmakers have considered a five-year freeze on physician pay rates beginning in 2011. Such a measure would likely cost $88.5 billion, and would be partially exempt from congressional pay-as-you-go rules, according to the American Medical News, which is affiliated with the American Medical Association. The cost of a permanent fix to the Medicare physician pay problem has increased almost exponentially over the last few years, according to AMNews. In 2003, the cost of a permanent fix was $49 billion. Five years from now, if nothing is done, that cost likely will reach $513, AMNews reported.