It’s an annual tradition: Thousands of white-coated physicians from across America descend on Washington for a week of lobbying Congress to fix a serious glitch in the Medicare program that will lead to a sizable cut in their payment rates.

The difference this time around is that the physicians’ lobby has just three months to make it happen.

Since 2002, the statutory formula used by the Centers for Medicare and Medicaid Services (CMS) to calculate how much doctors get paid for treating Medicare patients has mandated that the government reduce the fees.

The AMA and other medical societies warn that their current fees are not high enough to meet their expenses and caution that physicians will be compelled to stop treating Medicare beneficiaries if the situation is not resolved.

“Time is of the essence as this year’s cut of 10.6 percent starts in July, and 60 percent of physicians say this cut will force them to limit the number of new Medicare patients they can treat,” AMA Board Chairman Edward Langston said in a statement.

Although the AMA has made similar warnings every year, research conducted by the Medicare Payment Advisory Commission and others has not uncovered shortages of doctors for Medicare patients.

Nevertheless, lawmakers have gotten the message.

From 2003 on, Congress has stepped in to enact costly legislation to kick the can down the road and put in place stopgap measures to prevent the cuts. Although a true fix to the faulty formula has proven elusive due to its massive price tag — at least $50 billion over five years — lawmakers have at least made sure doctors’ payments didn’t go down.

The stakes for the AMA and its members are high, and the group’s lobbying expenditures reflect that. Last year, the AMA spent $22 million on lobbying, the most ever by the 161-year-old organization, according to the nonpartisan Center for Responsive Politics. Only the U.S. Chamber of Commerce, General Electric and the Pharmaceutical Research and Manufacturers of America spent more on lobbying in 2007.

The need for a Medicare physician fix during those years served to pull Congress forward on other Medicare issues, including making payment reductions to other medical providers to help free up money for the doctors. That, in turn, has set the stage for major lobbying efforts.

The AMA and the rest usually have all year to get action on the payment cuts, and it often takes Congress until December to put the finishing touches on the annual package.

This year, however, AMA members will arrive in Washington with very little time to get lawmakers to move on a bill. Because the legislation enacted at the end of last year only pushed the cut back six months, physicians will see a 10.6 percent fee reduction July 1 unless Congress acts fast.

The options available are not pretty, neither for Congress nor the doctors. They aren’t cheap, either, even for the most modest, short-term fixes.

According to a Congressional Budget Office estimate issued March 14, simply extending the pay rates at the current level for the rest of the year would cost taxpayers $2.1 billion. Under that least expensive method, fees would do down by 15 percent in 2009, presenting Congress with an even heavier lift next year.

Extending the zero percent update from July 1, 2008, through Dec. 31, 2009, would cost $8.1 billion and require a 20 percent cut in 2010.