On December 17, the Institute for Medical Freedom reported Congressional approval of a meager two-month extension on Medicare physician reimbursement. As all things political, things have gone from bad to worse since then as House Republicans, aptly unwilling to approve a two-month extension on a mammoth bill calling for an extension of a payroll tax holiday, jobless benefits, a statutory requirement for the President to decide on the future of the Keystone XL pipeline within 60 days, and the discontinuation of funding to the incandescent light bulb eradication program prepared Monday night to vote down the legislation that had been previously passed by the Senate, a move that seemed to surprise Senate Majority Leader, Harry Reid.

According to Senator Reid, and noted in public statements by House Speaker John Boehner, congressional leaders from both chambers had agreed to the two-month extension, prompting Reid to dismiss the Senate without recessing. However, despite the Senate’s passage of the bill, the House did not reciprocate the action. Now, with the House’s apparent refusal to approve the Senate’s legislation and voting on the measure delayed until Tuesday, final action will likely not take place until after January 1.

Congress’s failure to act in a timely manner will trigger the 27% reimbursement cut that neither party nor chamber ostensibly wishes to impose. To add insult to injury, the cut will be preceded by a 10 day freeze in payments to allow the Centers for Medicare and Medicaid Services, the administrative agency regulating the nation’s Medicare program, to reconfigure its computers, a move that will cripple cash flow to physician offices throughout the country. The interruption in income will of course be felt hardest by Southwest Florida practices where the largest accumulation of Medicare patients reside.

The harsh reality is that Medicare patients and their physicians form a very small percentage of the overall interests addressed in this bill. Consequently, providers are getting caught in the middle of a political tug of war that will engulf patients trying to access care.

The situation is a palpable one as evidenced by the practice closures that took place two years ago when some of Sarasota’s physicians were unable to cover their payroll obligations, forcing them to shut down.

Said one Sarasota radiologist, “This is shaping up just like two years ago. It seems we’re in for a very difficult year.”