On October 21, 2009, a Senate effort to block upcoming reductions to Medicare physician fee schedule payments failed on a procedural “cloture” vote that would have ended debate and allowed a vote on the bill. By way of background, under the current statutory “sustainable growth rate” (SGR) formula, Medicare physician payments are expected to be reduced by 21.5% in 2010 and by about 6% more annually for several subsequent years. The bill that came before the Senate, S. 1776, would repeal the SGR formula and permanently freeze the physician fee schedule. In blocking the measure, lawmakers voiced concerns about the proposal’s price tag (almost $250 billion over 10 years), which was not paid for under the bill.  Most recently, on October 29, 2009, House leaders released H.R. 3961, the Medicare Physician Payment Reform Act of 2009, which would provide a permanent fix to the physician fee schedule formula.  While Congress is widely expected act before the end of the year to avert the upcoming fee schedule cut for 2010, the timing and the scope of the legislation (permanent reform vs. one or two year fix) still has not been determined.