Long-term care providers could get an indication Mondaynight just how tough it could be to receive a favorable Medicare pay hike nextyear. The president is expected to unveil a proposal for changing the formulafor how doctors are paid during his State of the Union address. 

Long-term care leaders have feared that Congress will cutinto their available pool of funding for Medicare pay increases. Physicianswere in line for a 10% reimbursement cut at the end of 2007, but latelegislation granted them a 0.5% increase for six months instead. Now, they wantmore. 

Because Medicare trustees last year issued a fundingwarning, the president is bound by law to send a Medicare savings plan tolawmakers after he releases his 2009 budget proposal early next month. Manyobservers are skeptical that the president, facing a Congress controlled by theopposing party, will be able to advance much of his healthcare agenda – exceptwhen it comes to physician pay increases, which both major political partiesagree on.