# Plain Language Summary: SOAR Act of 2025

This bill makes significant changes to how Medicare pays for supplemental oxygen and related equipment and services. Currently, oxygen suppliers compete in a bidding program where they offer the lowest prices to win contracts, which has led to reduced payments and, according to the bill's supporters, limited patient access to quality oxygen services. Starting January 1, 2026, the SOAR Act removes oxygen from this competitive bidding system and instead sets payment rates based on the fees that were in place at the end of 2025, adjusted annually for inflation. For liquid oxygen specifically—which is more expensive but often necessary for patients who need mobility—the bill establishes a minimum payment floor of 200 percent of 2015 fee schedule rates, also adjusted for inflation. The bill also creates an extra payment for patients who need high-flow oxygen (6 liters per minute or more) to cover the additional oxygen costs.

The bill establishes detailed requirements for what oxygen suppliers must provide to receive Medicare payment. These include conducting thorough patient evaluations, ensuring patients have access to portable oxygen equipment for use outside the home, providing safety education, delivering equipment promptly before hospital discharge, offering 24-hour on-call support, and arranging backup suppliers if patients travel. Suppliers must also provide ongoing monitoring visits and equipment maintenance according to manufacturer specifications. Additionally, the bill requires Medicare to pay respiratory therapists directly for their services related to oxygen care, though the specific payment details aren't fully outlined in this section.

The bill also includes protections against fraud and abuse by requiring electronic templates to document medical necessity for oxygen therapy, allowing doctors to use their clinical judgment in determining whether patients need oxygen, and establishing notice requirements so patients know what services they're receiving. Finally, the bill creates specific beneficiary rights protections for people receiving oxygen services, ensuring they understand their coverage and have recourse if services are denied or inadequate. These changes are intended to improve patient access to oxygen therapy while maintaining program integrity and preventing unnecessary services.

SOAR Act of 2025

Valadao, David G.

Supplemental Oxygen Access Reform Act of 2025&nbsp;or the SOAR Act of 2025This bill establishes certain requirements with respect to the payment and provision of supplemental oxygen and related services under Medicare.For example, the bill provides for separate payments, indexed to inflation, of oxygen and related equipment, supplies, and services under Medicare (rather than under the competitive acquisition program). It also specifically covers services that are provided by respiratory therapists under Medicare and provides for an additional payment adjustment for these services.Additionally, the bill (1) requires the Centers for Medicare &amp; Medicaid Services to develop an electronic template for providers to use when prescribing oxygen and related equipment, supplies, and services; and (2) establishes certain rights for beneficiaries receiving these items and services, such as the right to choose their suppliers and to receive clear communications and be informed about the services provided.