On November 19, 2009, the House of Representatives approved H.R. 3961, the Medicare Physician Payment Reform Act, by a vote of 243-183.  The bill would block a 21.2% Medicare physician fee reduction scheduled to go into effect January 1, 2010, and would replace the current sustainable growth rate formula for calculating physician payments with a new update methodology. Most notably, under the House plan, the fee schedule update for 2010 would equal the percentage increase in the Medicare economic index (1.2%). Beginning in 2011, there would be separate target growth rates and conversion factor updates for two categories of service: (1) evaluation, management, and preventive services (updates would be set at the GDP growth rate plus 2 percentage points per year), and (2) all other services (which would be updated by the GDP plus 1 percentage point). The CBO estimates that the bill would increase Medicare payments to physicians by about $195 billion over 10 years. Note that in October, the Senate blocked consideration of a separate bill (S. 1776) to address physician fee schedule payments, so it is uncertain when or if the Senate will consider the new House measure. The Senate health reform plan (discussed above) includes a more limited, one-year fix of the fee schedule, which would provide a 0.5% update for 2010. While Congress eventually is expected to take legislative action to avert the upcoming fee schedule cut for 2010, the timing and the scope of the legislation (permanent reform vs. a temporary fix) is still unclear.