For sev­er­al years Con­gress has been forced to fix the Medicare “sus­tain­able growth rate for­mu­la” so that doc­tors could con­tin­ue to receive a fair amount for ser­vices per­formed. Each year there is a threat, begun with the pas­sage of the Afford­able Care Act, that doc­tor fees will be cut by 21%. Doc­tors aren’t paid sub­stan­tial­ly by Medicare as it is, and the 21% pay cut threat­ened access for patients, as many doc­tors threat­ened to stop tak­ing Medicare patients. Con­gress passed a series of one year “fix­es” but now the Pres­i­dent has signed a bipar­ti­san bill that elim­i­nates the cut once and for all.