SOAR Act of 2025
Summary
What This Bill Does
The bill exempts medicare supplemental oxygen benefit payment reform - excludes oxygen from competitive acquisition program, establishes new fee-schedule-based payment amounts with CPI adjustments, special liquid oxygen payment, requires scope of services requirements for supplemental oxygen suppliers including initial evaluation, portable access, education, delivery, infection control, monitoring, exception reporting, and 24-hour coverage, and creates new Medicare-covered service category for respiratory therapist services and establishes a non-budget-neutral add-on payment adjustment for respiratory therapist services furnished on or after January 1, 2026. It relies on compliance mandates, price controls, product standards, and reporting requirements. The main policy areas are Healthcare.
Who Benefits and How
Respiratory therapists could gain revenue opportunities, DME oxygen equipment suppliers could gain revenue opportunities, and Medicare beneficiaries receiving oxygen services could face reduced risk.
Who Bears the Burden and How
DME oxygen equipment suppliers would take on compliance duties, Medicare Trust Fund could face higher costs, and CMS would take on compliance duties.
Key Provisions
- Exempts medicare supplemental oxygen benefit payment reform - excludes oxygen from competitive acquisition program, establishes new fee-schedule-based payment amounts with CPI adjustments, special liquid oxygen payment...
- Requires scope of services requirements for supplemental oxygen suppliers including initial evaluation, portable access, education, delivery, infection control, monitoring, exception reporting, and 24-hour coverage.
- Creates new Medicare-covered service category for respiratory therapist services and establishes a non-budget-neutral add-on payment adjustment for respiratory therapist services furnished on or after January 1, 2026.
- Requires adoption of electronic templates for documenting medical necessity of oxygen services and restoration of pre-2009 clinical inference and clinical judgment standards for payment audits of oxygen suppliers.
- Requires notice requirements for Medicare oxygen beneficiaries including description of 36-month rental period, right to discuss prescription with physician, cost sharing termination, grievance processes, and monthly...
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
The bill exempts medicare supplemental oxygen benefit payment reform - excludes oxygen from competitive acquisition program, establishes new fee-schedule-based payment amounts with CPI adjustments, special liquid oxygen payment, requires scope of services requirements for supplemental oxygen suppliers including initial evaluation, portable access, education, delivery, infection control, monitoring, exception reporting, and 24-hour coverage, and creates new Medicare-covered service category for respiratory therapist services and establishes a non-budget-neutral add-on payment adjustment for respiratory therapist services furnished on or after January 1, 2026.
Key Policy Areas
Healthcare
Primary Purpose
The bill exempts medicare supplemental oxygen benefit payment reform - excludes oxygen from competitive acquisition program, establishes new fee-schedule-based payment amounts with CPI adjustments, special liquid oxygen payment, requires scope of services requirements for supplemental oxygen suppliers including initial evaluation, portable access, education, delivery, infection control, monitoring, exception reporting, and 24-hour coverage, and creates new Medicare-covered service category for respiratory therapist services and establishes a non-budget-neutral add-on payment adjustment for respiratory therapist services furnished on or after January 1, 2026.
Policy Domains
Whole bill
Identified Gains
- Respiratory therapists
- DME oxygen equipment suppliers
- Medicare beneficiaries receiving oxygen services
- Liquid oxygen suppliers and manufacturers
- Medicare beneficiaries receiving supplemental oxygen
Identified Costs
- DME oxygen equipment suppliers
- Medicare Trust Fund
- CMS
- Medicare Administrative Contractors
Sponsors
Legislative Progress
In CommitteeMr. Valadao (for himself, Ms. Brownley, Mr. Smith of Nebraska, …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
DME oxygen equipment suppliers, Liquid oxygen suppliers and manufacturers, Medicare beneficiaries receiving oxygen services
DME oxygen equipment suppliers faces effects in multiple directions
CMS, Medicare Administrative Contractors, Medicare Trust Fund
Prescribing physicians and practitioners, Respiratory therapists
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology