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A bill to fix the way Medicare pays doctors is heading to President Obama’s desk after the Senate overwhelmingly approved it in a 92-8 vote Tuesday night. The bipartisan bill cleared the House last month and means doctors no longer have to face a 21 percent cut in Medicare fees after a deadline this week. The measure changes payments to focus on quality and value rather than volume of services, and also extends the Children’s Health Insurance Program for two more years through 2017. Obama, who endorsed the bill, is expected to sign it.