Sierra Nevada Cardiology says it's not a done deal yet, but if the 40-percent proposed cuts in Medicare reimbursement go through, it may mean clinics close down, and patients may be sent to regional hospitals for testing.

If you've had heart problems you’ll undergo certain imaging tests which help doctors determine if you're heart is working properly, and if not, where the problem lies. Manny Barba has three stents to help blood flow smoothly through the heart vessels. He says his insurance has helped make it all possible.

“Well between Medicare and the insurance they pay for everything, I don't even have a co-pay,” says Barba

But proposed Medicare cuts may make Manny's usual and customary medical care anything but usual--especially if the patient lives in a rural part of Nevada.

“The large states where people have to drive several hundred miles to get medical care its going to be impossible or a disaster for them,” says Dr. Kosta Arger, a Cardiologist with Sierra Nevada Cardology.

Dr. Arger says Congress is looking at cutting reimbursement to practices like his, which means that practice will be unable to afford to offer certain diagnostic tests like echo-cardiograms or stress tests. The results, he says: their clinics in the rural areas will be shut down, and patients will have to go to hospitals for that same testing. In the end, longer travel, longer lines, and waiting longer for test results.

“I think its going to affect all Medicare patients across the board. Whether it's a urologic problem, a cardiac procedure or any other procedure that requires what we call imaging for testing. MRI, CAT Scans, XRAYS of any sort,” says Dr. Arger.

What's interesting to note is that reimbursing hospitals as opposed to clinics will actually cost Medicare more.

Its important to remember these cuts are not connected to the health care reform debate.