The Senate just voted to advance H.R. 4851 (the "Continuing Extension Act") to a final vote. This bill puts in a place a 30-day Medicare pay fix effective from April 1 to April 30. While you and your peers probably see the pay fix as this bill's biggest provision, the mainstream media will probably be calling this the short-term jobless benefits bill, because this legislation also extends jobless benefits until May 5.

NOTE: Technically the bill hasn't yet passed; this vote was to invoke cloture. But the cloture vote means actual passage is just a formality at this point.

The lack of support for health care reform tabulated in our Part B News poll isn't surprising. There are lots of reasons - some more relevant than others -- to dislike the bill as opposed to liking the bill. Most Americans not in the medical profession probably feel the same way. As I previously stated, I have my own reservations for our new health care reform law.

You can go through the law and question the legitimacy of any section - especially the Medicare provisions. Why mandate a Medicare claim be submitted within 12 months or it will be rejected as untimely? How did Congress decide on 12 months? Why not six months or 18 months? Why tweak the timely claims section of the Medicare manual at all?

Certainly, there are some provisions in the bill America likes. Removing "barriers" such as patient copays and deductibles to preventive care and paying for annual Medicare check-ups seems like a good idea. Most Medicare physicians providing primary care must support the new wellness exam. At least they should welcome a new reimbursement opportunity.

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Many people thought 2010 would be the year of the permanent Medicare payment fix, that health reform would bring along the end of the flawed sustainable growth rate (SGR) formula. Nope, that just won't be so, says a top industry lobbyist. "If I was a betting man, no, not going to happen," he told me in an off-the-record conversation last week. I can't disclose his name, his organization or even what type of group he represents, but I can tell you he's been sitting in all those secret, behind-closed-doors discussions with top Democrats that you've been hearing about on cable news shows. I wouldn't bet against his bet.

Providers no longer have 15 to 26 months to file Medicare claims. The Patient Protection and Affordable Care Act (PPACA) now requires practices to submit claims within 12 months of the date of service.

So, a claim for any service provided to a Medicare patient in 2010 will need to be submitted one calendar year later. But there are a few wrinkles to keep in mind:

• Claims for services between Oct. 1, 2009, and Dec. 31, 2009, need to be submitted by Dec. 31, 2010.
• Claims for services rendered before Oct. 1, 2009, will follow the previous rules for timely Medicare claims.

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I had the opportunity to chat with Rep. Michael Burgess, MD,  for a good 20 minutes yesterday. Dr. Burgess, a self-described "simple country doctor," spent almost 30 years as a practicing OB/GYN in Texas before being elected to the U.S. House of Representatives in 2002. Here's a transcript covering our conversation about the 21% Medicare pay cut hovering on the horizon, and why Congress has dealt with it in fits and starts this year.