S. 1406: Supplemental Oxygen Access Reform Act of 2025

The Supplemental Oxygen Access Reform Act of 2025 (also known as the SOAR Act) aims to improve access to supplemental oxygen and related services for beneficiaries within the Medicare system. The bill covers various aspects related to Medicare's coverage of oxygen therapy and respiratory services. Here is a summary of the key provisions of the bill:

Title I - Protecting Access to Supplemental Oxygen Therapy

Reform of Medicare Supplemental Oxygen Benefit

• The bill proposes to remove oxygen and related equipment from the competitive acquisition program, enhancing patient access.
• From January 1, 2026, payments for oxygen and equipment will follow new guidelines to improve accessibility, ensuring that Medicare reimburses appropriately for these critical supplies.

Establishing Payment Adequacy

• It sets forth methods for Medicare to determine payment amounts for oxygen services, accounting for cost-of-living adjustments based on the Consumer Price Index in various regions.
• Special provisions are included for liquid oxygen, requiring Medicare to establish a separate payment that reflects current costs and needs.

Title II - Access to Respiratory Therapists

Reimbursement for Respiratory Therapists

• The bill aims to include respiratory therapy services explicitly in the definition of Medicare-covered services.
• It establishes payment adjustments for providers of respiratory therapy services starting January 1, 2026.

Title III - Strengthening Program Integrity

Use of Electronic Templates

• The Secretary of Health and Human Services will implement electronic templates that document medical necessity for oxygen services.
• Restoration of clinical judgment in evaluating claims will be prioritized, improving reliability in service coverage assessments.

Title IV - Establishing Beneficiary Rights

Rights for Individuals Receiving Oxygen Services

• The bill recognizes specific rights for beneficiaries, including the choice of suppliers and the right to receive comprehensive information about services provided.
• Beneficiaries will be informed about patient responsibilities, equipment maintenance, and how to address grievances, ensuring they can seek recourse if needed.
• Suppliers will be required to provide timely assistance and maintain patients' mobility with the necessary oxygen equipment and supplies.

Relevant Companies

• AIRG - A company that may be involved in the supply and distribution of oxygen equipment and services, potentially impacted by changes in Medicare reimbursement rates.
• HSIC - A medical equipment supplier that provides respiratory care products, likely to be affected by regulatory changes related to payment reforms.