The Senate voted down a bill this week that would have temporarily avoided the impending 21% cuts in Medicare physician fees.  Although those cuts technically took effect on June 1, 2010, the Centers for Medicare and Medicaid put a hold on physician payments until tomorrow to give Congress time to pass the legislation.  The bill in question has been kicking around Congress since April.  In light of the current bill’s defeat in the Senate, if and when the Senate approves a revised bill, it will then need to go back to the House for approval.  This added delay likely means the fee cuts will kick in, even if only temporarily, until a fix is ultimately passed.