On January 28, the Senate approved legislation that will increase the federal debt limit to $1.9 trillion. Included in this legislation was a provision to reinstate "pay-go" rules mandating that Congress must offset any future increased spending with corresponding spending reductions or revenue increases.  This bill also provides Congress a 5 year exemption from these pay-go rules to address the Medicare physician payment cut. However, this provision does not provide any funding. The current freeze on the 2009 Medicare conversion factor is scheduled to expire on Feb. 28. Any solution still requires House and Presidential approval.