Ricardo Alonso-Zaldivar & Stephen Ohlemacher, AP

Last Friday the Senate passed legislation to spare doctors a 21 percent cut in Medicare payments that had been looming for months, but the last-ditch effort came too late. Moments after the Senate acted, Medicare announced it would begin processing claims it has already received for June at the lower rate. The reason: the House cannot act on the fix until this week.

That means doctors, nurse practitioners, physical therapists and other providers who bill under Medicare's physician fee schedule will have to resubmit their claims if they want to be made whole, with added paperwork costs both for the providers and for taxpayers.

“Congress is playing Russian roulette with seniors' health care,” Dr. Cecil B. Wilson, president of the American Medical Association, said in a statement. “This is no way to run a major health coverage program.” The billings affected by the cut cover the early part of this month. An earlier congressional reprieve expired May 31. Medicare had been holding off on processing claims in the hopes lawmakers would act, but the agency said it can no longer do that without hurting doctors' cash flow.

The Medicare cuts are required under a 1990s budget-cutting law that Congress has routinely waived. This time, lawmakers' concerns about adding to the deficit held up a deal to allow an exception to enforcement of the law. The bill passed by the Senate delays the cuts until the end of November — after congressional elections — when lawmakers hope the political climate is better for passing a more permanent and expensive, solution.

The bill would also increase payments to providers by 2.2 percent. The legislation, which costs about $6.5 billion, is paid for with a series of health care and pension changes that both Democrats and Republicans agreed to. The Senate approved the measure by voice vote Friday after failing the night before to pass a larger package that included the funds.

The larger package included jobless benefits for the long-term unemployed, aid to cash-strapped states and the extension of dozens of popular tax breaks for businesses and individuals that expired at the end of last year. The package failed to generate enough votes Thursday evening to end a Republican filibuster

Vice President Joe Biden, speaking before the Senate acted, blamed Republicans for being unwilling go along with a permanent fix to the doctor cuts — which would cost tens of billions more. He said the underlying physician payment formula is unworkable, and should be repealed.

The political gridlock has angered doctors. The AMA says continuing financial uncertainty may lead some doctors to stop taking new Medicare patients, and others may drop out of the program altogether. “It is astounding that Congress has let seniors down through their inability to deal with this problem on time and in a responsible fashion,” Wilson said.