From The Hill:
The Senate left town Thursday night for a week and a half after passing billions in domestic spending initiatives and a new GI Bill but falling a single vote short of passing Medicare legislation that would have prevented pay cuts to physicians. [...] The Medicare legislation would have blocked a 10.6 percent fee cut to physicians that is scheduled to take effect on July 1. It failed 58-40, two shy of the required 60, but Majority Leader Harry Reid (D-Nev.) switched his vote to “no” as a procedural move that allows him to bring the bill back up for a future vote. Sens. Edward Kennedy (D-Mass.) and GOP presidential candidate John McCain (R-Ariz.) missed the vote.Fun fact: McCain has not shown up to the Senate to cast a vote since April. His would have been the deciding vote.
Republicans oppose the temporary SGR fix because funds to pay for it were obtained by reducing the size of the Medicare Advantage plans.
The net effect here is that as of next week, physicians can expect to see that 10.6% cut in compensation from all their Medicare patients. Perhaps there will be a stop-gap fix while a compromise is worked out, or perhaps, as in 2006, the ultimate solution will be retroactive to July 1. The conventional wisdom is that the cuts will eventually be stayed, but once they are implemented, and become the status quo, the higher the likelihood that the remedy will not appear and we will be stuck with the lower rates, or that a fix, if it comes, may be less than initially expected.