Image of male nurse pushing senior woman in a wheelchair in nursing facility

Doctors still face a 21% Medicare payment cut next year after the Senate this week voted 53-47 against a permanent fix to the doctor reimbursement formula.

The bill, which was expected to cost $247 billion over the next decade, would have replaced the cuts with a 10-year payment rate freeze. Senate Republicans and a dozen Democrats worried that the multiyear fix would be too expensive given the current economic climate. Each year since the Medicare physician pay formula was enacted in 1997, Congress has enacted a temporary fix. While consensus in Washington is that a permanent fix is needed, cost remains the deciding factor.

There is still hope for physicians and the millions of seniors who would potentially be denied service if the cuts take effect on Jan. 1. The Senate Finance Committee version of healthcare reform would replace the cut with a 0.5% increase in 2010. Also, sponsors of the failed bill have said they will address the issue again once healthcare reform has been settled. Healthcare reform legislation is proposing deep cuts to Medicare in all segments of healthcare, including the nursing home field.