On December 15, 2010, President Obama signed the Medicare and Medicaid Extenders Act of 2010 which provides a one year delay in the implementation of the Sustainable Growth Rate (SGR) Formula for Medicare funding. Absent this “fix,” implementation of the SGR would have resulted in a 25% reduction of Medicare program reimbursement to physicians, effective as of January 1, 2011. This is the fifth time Congress has acted to delay implementation of the SGR. The legislation also extends other expiring Medicare and Medicaid payment provisions, makes additional clarifications and adjustments to both programs and changes the limits on the amount of excess health insurance tax credits that must be repaid to the federal government. Congress has now delayed addressing the SGR five times and no permanent solution is on the horizon.