Thanks to the American Health Lawyers for this summary, dated October 19, 2009.Senate Democrats have postponed a scheduled cloture vote today on a bill that would make permanent changes to scheduled rate cuts to Medicare reimbursement for doctors and hospitals. Meanwhile, doctors worry about the cuts and lawmakers worry that the fix could break budget goals.The New York Times Prescriptions Blog reports that the American Medical Association is broadcasting a new television commercial endorsing the Senate bill. "S. 1776 is a Senate bill that would permanently adjust a Medicare payment formula that for years has threatened to impose steep annual cuts in the rates that doctors are paid," according to the Times. "The formula, tracing to laws passed in 1989 and 1997, was devised to keep Medicare spending in check." In recent years, though, congressional lawmakers have intervened with a "patch, known on Capitol Hill as the annual 'doc fix,' to prevent the cuts." Currently, Democrats have no plans "to offset the cost of S. 1776, which is why they are eager to keep it separate from the broader health care legislation and avoid breaking the president's promise [that health reform would not add to the deficit]." They insist "fixing the doctor payment formula should not count toward the cost of the big health care legislation, because it is a problem they inherited. What they have trouble explaining, though, is how the flawed formula is different from any of the zillion other entrenched problems in the health care system that the proposed overhaul aims to fix" (Herszenhorn, 10/18). The Hill Blog reports on the decision to postpone today's vote: "Initially, Senate Majority Leader Harry Reid (D-Nev.) scheduled his motion to end floor debate and bring the so-called 'doc fix bill' to a final vote at the beginning of next week. But the leader reportedly changed his mind on Friday, deciding instead to vitiate Monday's vote so both parties' lawmakers could broker an agreement on a few remaining amendments, his office said Sunday. Reid's office did not specify what those amendments might be, but Republicans have previously suggested they hoped to add pay-fors to the Democrats' bill in an attempt to reduce its $248-billion footprint . . . . Nevertheless, it is unclear when Democrats will attempt cloture next, but it could be as soon as later this week" (Romm, 10/18)