This is constantly happening these days.  As more and more state budgets are looking for revenues these physician taxes are going to be continually brought up.  What people fail to understand is the Federal Government pays less than 26 cents on the dollar.  This is in the face of a Sustainable Growth Rate formula that is flawed.  The formula pays doctors.  Each year a fix has to be put into place because of threatened cuts in payments to physicians who care for Medicare patients.  I am heading to Capitol Hill tomorrow to try and get some information regarding future plans to eliminate this formula or replace it with another.  Each year I have traveled to Capitol Hill over the past several years no one has been very interested in discussing this issue or others related to Medicare.  I am interested to see their level of interest now!