On Tuesday evening, April 14, the U.S. Senate passed legislation ending the Sustainable Growth Rate (SGR) formula whose problematic history has plagued Medicare physician payment issues for over a decade, as it approved the Medicare and CHIP Reauthorization Act (MACRA), which President Barack Obama is expected to sign before midnight eastern time, according to press reports. The House of Representatives had approved the bill by a vote of 392 to 37 on March 26, just before a two-week recess.