On January 1, 2012, a 27.4% cut in Medicare payment rates to physicians will take effect due to the Sustainable Growth Rate formula. Congress has intervened to prevent these projected cuts annually since 2002. As the deadline approaches, Congress, the administration, and other government agencies are deciding whether to pass another short-term “doc fix,” or find a longer-term solution. A new policy briefby Health Affairs provides the history of this issue, examines some of the proposals under consideration, and suggests what might come next.