SOAR Act of 2025

The Supplemental Oxygen Access Reform (SOAR) Act of 2025 seeks to significantly improve the Medicare payment method for oxygen and oxygen-related equipment, supplies, and services, ultimately enhancing beneficiary access. A core provision removes oxygen and related items from the competitive acquisition program under Medicare, effective January 1, 2026. Instead, it establishes new payment methodologies, with specific rates for competitive bidding areas, rural and non-contiguous areas, and other regions, updated annually by the consumer price index. The bill introduces a special rule for liquid oxygen , requiring the Secretary to establish a separate payment amount no less than 200 percent of the 2015 Durable Medical Equipment fee schedule, updated by inflation. This payment will include an add-on for high-flow patients and mandates periodic assessments of the base rate. Furthermore, the legislation defines comprehensive responsibilities for oxygen suppliers, including initial beneficiary evaluations, ensuring access to portable oxygen, providing extensive education, timely delivery, equipment maintenance, and offering 24-hour on-call coverage. To protect beneficiary access, the bill adds respiratory therapist services to the definition of medical and other health services covered by Medicare, effective January 1, 2026. It also mandates a non-budget neutral add-on payment adjustment for these services. For program integrity, the Act requires the adoption of electronic templates for prescribing practitioners to document medical necessity for oxygen, and restores the use of clinical inference and judgment in payment audits for oxygen suppliers, similar to practices before 2009. Finally, the SOAR Act establishes new beneficiary rights and protections . It mandates annual notices to beneficiaries about cost-sharing obligations, the 36-month rental period, and grievance processes. Beneficiaries will also receive monthly notices indicating the remaining months of their cost-sharing period. Key rights include choosing and changing suppliers, receiving clear communication, ensuring privacy, being informed about treatment and financial responsibilities, receiving appropriate equipment for mobility, and having procedures for equipment repair and involuntary discharge.