The ACC flew 15 of its leaders to Washington, D.C., this week to meet with the House and Senate leadership. The timing was excellent given that negotiations on a Medicare bill in the Senate intensified this week in the pre-Memorial Day recess crunch. The news from meetings with members of the Senate Finance Committee was that bipartisan negotiations on a Medicare bill have not progressed. While both sides agree on providing physicians with 18 months of relief from cuts, neither side will budge on a few sticking points, the biggest being the use of Medicare Advantage cuts to offset the cost of the bill. We reiterated the need for 18 months of positive updates to provide some stability to physician practices and get us into the next Administration and Congress, where we hope the environment for reform will be better. Besides learning the latest on the Medicare bill from Senate Finance Committee Chair Max Baucus and Ranking Member Charles Grassley, several ACC leaders had a thoughtful discussion with House Speaker Pelosi’s staff about the need for system reform and the role ACC’s registries and other initiatives can play in improving quality and reducing costs. This was good advocacy — BUT the SGR band-aid process is not looking good right now, much less getting real system reform financed.