To amend title XVIII of the Social Security Act to improve the payment method for oxygen and oxygen related equipment, supplies, and services, to increase beneficiary access to oxygen and oxygen related equipment, supplies, and services, and for other purposes.
Sponsors
Legislative Progress
IntroducedMr. Cassidy (for himself, Ms. Klobuchar, and Mr. Warner) introduced …
Summary
What This Bill Does
The Supplemental Oxygen Access Reform Act of 2025 (SOAR Act) overhauls how Medicare pays for oxygen equipment, supplies, and services for beneficiaries who need supplemental oxygen therapy. It removes oxygen from Medicare's competitive bidding program and establishes new reimbursement formulas that significantly increase payment rates to suppliers, while also adding coverage for respiratory therapist services and expanding patient protections.
Who Benefits and How
- Durable medical equipment (DME) suppliers/oxygen providers benefit the most - they receive substantially higher reimbursement rates, with liquid oxygen payments set at a minimum of 200% of the 2015 fee schedule (inflation-adjusted), and all oxygen payments excluded from the cost-cutting competitive bidding program. They also receive annual CPI-based payment increases.
- Respiratory therapists gain new Medicare coverage for their services starting January 1, 2026, with a dedicated "non-budget neutral add-on payment" for their assessment and monitoring work.
- Medicare beneficiaries requiring oxygen therapy gain better access to services, stronger patient rights protections, portable oxygen access based on mobility needs, clear notice of their cost-sharing obligations, and grievance procedures.
- Oxygen equipment manufacturers benefit from increased demand as suppliers receive better reimbursement.
Who Bears the Burden and How
- The Medicare program faces significantly increased costs due to higher reimbursement rates (the bill explicitly uses "non-budget neutral" language, meaning it does not offset the new spending). The 200% payment floor for liquid oxygen alone represents a major cost increase.
- Medicare Administrative Contractors must implement new electronic claims processing systems, create uniform patient evaluation templates, and use "clinical inference" in payment audits rather than strict documentation requirements.
Key Provisions
- Excludes all oxygen equipment, supplies, and services from Medicare's competitive acquisition program effective January 1, 2026
- Establishes tiered payment rates: competitive bidding areas use 2025 fee schedule rates with annual CPI increases; rural/non-contiguous areas receive a blend of 110% national average and local rates; other areas receive 75%/25% blend
- Sets liquid oxygen payment floor at 200% of the 2015 fee schedule (inflation-adjusted) with mandatory annual CPI increases
- Creates add-on payments for high-flow oxygen patients (6+ liters per minute) and for respiratory therapist services
- Requires suppliers to provide comprehensive services including initial evaluation, portable oxygen access, patient education, 24-hour coverage, and emergency response coordination
- Establishes electronic documentation templates to streamline medical necessity determinations and restore "clinical inference" in audits
- Creates detailed beneficiary protection rights including supplier choice, clear cost-sharing notices, grievance procedures, and anti-retaliation protections
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Reforms Medicare reimbursement for supplemental oxygen equipment, supplies, and services to ensure adequate payment rates and coverage for beneficiaries requiring oxygen therapy
Policy Domains
Legislative Strategy
"Increase Medicare reimbursement rates for oxygen suppliers and add coverage for respiratory therapist services while strengthening program integrity and beneficiary protections"
Likely Beneficiaries
- Durable medical equipment suppliers (oxygen providers)
- Respiratory therapists
- Medicare beneficiaries requiring oxygen therapy
- Oxygen equipment manufacturers
Likely Burden Bearers
- Medicare program (increased costs)
- Medicare Administrative Contractors (new administrative requirements)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
Services performed by a respiratory therapist within scope of practice as defined by State law for assessment, treatment, and monitoring of patients requiring oxygen
Payment amounts for oxygen excluded from competitive acquisition program, with different rates for competitive bidding areas, rural/non-contiguous areas, and other areas
Scope of services suppliers must provide including initial evaluation, portable oxygen access, beneficiary education, equipment delivery and setup, monitoring, 24-hour coverage, etc.
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