I 

111TH CONGRESS 

1ST SESSION H. R. 3220 

To amend title XVIII of the Social Security Act to reform Medicare coverage 

and reimbursement for home oxygen therapy services. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 15, 2009 

Mr. ROSS (for himself and Mr. MEEK of Florida) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to reform 

Medicare coverage and reimbursement for home oxygen 

therapy services. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Home Oxy5 gen Therapy Act of 2009’’. 


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1 SEC. 2. TREATMENT OF HOME OXYGEN THERAPY SEPA2 RATE FROM DURABLE MEDICAL EQUIPMENT. 

3 (a) ELIMINATION FROM DEFINITION OF DURABLE

4 MEDICAL EQUIPMENT.—Section 1861(n) of the Social Se5 curity Act (42 U.S.C. 1395x(n)) is amended— 

6 (1) by striking ‘‘oxygen tents,’’; and 

7 (2) by adding at the end the following new sen8 tence: ‘‘Such term does not include oxygen and home 

9 oxygen therapy services.’’. 

10 (b) CONFORMING AMENDMENTS.— 

11 (1) Section 1834(a) of the Social Security Act 

12 (42 U.S.C. 1395m(a)) is amended— 

13 (A) by striking paragraphs (5) and (9); 

14 (B) in paragraph (6), by striking ‘‘(4), or 

15 (5)’’ and inserting ‘‘or (4)’’; and 

16 (C) in paragraph (21)(B), by striking ‘‘ox17 ygen and oxygen equipment,’’. 

18 (2) Section 1847(a) of such Act (42 U.S.C. 

19 1395w–3(a)) is amended— 

20 (A) in paragraph (1)(D)(i)— 

21 (i) in subclause (II), by striking ‘‘and 

22 (IV)’’ and inserting ‘‘, (IV), and (V)’’; 

23 (ii) by striking ‘‘and’’ at the end of 

24 subclause (III); 


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1 (iii) by striking the period at the end 

2 of subclause (IV) and inserting ‘‘; and’’; 

3 and 

4 (iv) by adding at the end the following 

5 new subclause: 

6 ‘‘(V) the Secretary shall exclude 

7 oxygen and oxygen equipment.’’; 

8 (B) in paragraph (2), by inserting ‘‘(and 

9 do not include oxygen and oxygen equipment)’’ 

10 after ‘‘are the following’’; and 

11 (C) in paragraph (4)— 

12 (i) by striking ‘‘AND OXYGEN’’ in the 

13 heading; 

14 (ii) by striking ‘‘and in the case of 

15 payment for oxygen under section 

16 1834(a)(5)’’; and 

17 (iii) by striking ‘‘and supply arrange18 ments with oxygen suppliers’’. 

19 SEC. 3. COVERAGE OF HOME OXYGEN THERAPY SERVICES. 

20 (a) DEFINITIONS.—Section 1861 of the Social Secu21 rity Act is amended by adding at the end the following 

22 new subsection: 

23 ‘‘Home Oxygen Therapy Services 

24 ‘‘(hhh)(1) IN GENERAL.—The term ‘home oxygen 

25 therapy services’ means services and supplies furnished by 


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1 a qualified home oxygen therapy provider and includes, 

2 with respect to an individual, the following furnished by 

3 home oxygen therapy provider (as defined in paragraph 

4 (2)). 

5 ‘‘(A) Conducting an initial evaluation of the in6 dividual using a uniform Oxygen Patient Evaluation 

7 Form developed, in consultation with the Home Oxy8 gen Therapy Advisory Committee, by the Secretary. 

9 ‘‘(B) Providing written and verbal individual 

10 and caregiver education about home oxygen therapy, 

11 stationary and portable oxygen therapy options, and 

12 oxygen safety (such as evaluating the home environ13 ment for safety risks or hazards, including home fire 

14 and fall prevention). 

15 ‘‘(C) Providing appropriate delivery, set-up, and 

16 coordination of oxygen (such as delivery of oxygen 

17 technology to hospital prior to discharge, delivery 

18 and set-up of equipment in the home), as needed, in 

19 a timely manner as agreed upon by the individual or 

20 caregiver (or both), the home oxygen therapy pro21 vider, and the physician. 

22 ‘‘(D) Evaluating the individual’s ability to oper23 ate the oxygen equipment safely and effectively. 


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1 ‘‘(E) Educating and, when necessary, providing 

2 assistance with infection control, focusing on keeping 

3 oxygen equipment from leading to infection. 

4 ‘‘(F) Providing equipment-related services con5 sistent with the manufacturer specifications and in 

6 accordance with all Federal, State, and local laws 

7 and regulations, which may include checking oxygen 

8 system purity levels and flow rates, changing and 

9 cleaning filters, and assuring the integrity of alarms 

10 and back-up systems. 

11 ‘‘(G) Monitoring visits by appropriately trained 

12 personnel to evaluate all aspects of the services 

13 being provided to the individual by the home oxygen 

14 therapy provider, including ensuring that individual 

15 is following the prescribed plan of care. 

16 ‘‘(H) Documenting exception reporting by the 

17 home oxygen therapy provider when changes occur 

18 in the individual’s compliance with the plan of care 

19 to the prescribing physician. 

20 ‘‘(I) Providing, as needed, continued education 

21 regarding appropriate home oxygen equipment main22 tenance practices and performance by the individual 

23 and caregivers. 


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1 ‘‘(J) Implementing all home oxygen therapy 

2 services that are prescribed by the physician’s plan 

3 of care. 

4 ‘‘(K) Providing, as needed, appropriate home 

5 oxygen equipment, supplies, including supplemental 

6 supplies and emergency oxygen back-ups as appro7 priate. 

8 ‘‘(L) Providing 24-hour on-call coverage to re9 spond to individual’s needs with home oxygen ther10 apy. 

11 ‘‘(M) Assisting the individual with the coordina12 tion of oxygen equipment, services, and providers if 

13 the individual travels outside of the provider’s serv14 ice area. 

15 If an individual relocates permanently, the new home oxy16 gen therapy provider for the individual shall assume re17 sponsibility for billing the Medicare program directly. The 

18 Secretary is directed to determine which of these covered 

19 services must be performed in person. 

20 ‘‘(2) QUALIFIED HOME OXYGEN THERAPY PRO21 VIDER.— 

22 ‘‘(A) The term ‘qualified home oxygen therapy 

23 provider’ means an entity that provides home oxygen 

24 therapy services and home oxygen equipment— 


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1 ‘‘(i) furnishes home oxygen therapy serv2 ices in compliance with applicable laws, rules, 

3 and regulations to individuals in their homes, 

4 pursuant to a physician’s order; 

5 ‘‘(ii) is accredited by an accreditation orga6 nization (including organizations deemed as of 

7 November 2006 by the Secretary to accredit 

8 durable medical equipment suppliers) that of9 fers home medical equipment or respiratory 

10 service accreditation services; 

11 ‘‘(iii) complies with the Durable Medical 

12 Equipment, Prosthetics, Orthotics and Supplies 

13 Quality Standards adopted by the Secretary in 

14 October 2008; and 

15 ‘‘(iv) complies with the Durable Medical 

16 Equipment, Prosthetics, Orthotics and Supplies 

17 Supplier Standards as set forth at section 

18 424.57(c) of title 42, Code of Federal Regula19 tions). 

20 ‘‘(B) A qualified home oxygen therapy provider 

21 may determine which oxygen delivery system meets 

22 the requirements of the prescribing physician’s order 

23 and is appropriate for an individual based upon the 

24 physician’s classification of the individual in a pa25 tient category. 


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1 ‘‘(C) Nothing in this subsection shall be con2 strued to establish a Federal requirement that a 

3 qualified home oxygen therapy provider employ or 

4 otherwise retain a licensed respiratory therapist to 

5 furnish services for which State law does not require 

6 them to be furnished by such a licensed respiratory 

7 therapist. 

8 ‘‘(D) Nothing in this title shall be construed as 

9 authorizing the Secretary to require an entity that 

10 is a qualified home oxygen therapy provider— 

11 ‘‘(i) to obtain more than one National Pro12 vider Identifier for each location in which the 

13 provider operates, notwithstanding that the pro14 vider also furnishes durable medical equipment 

15 under this title; 

16 ‘‘(ii) to obtain a surety bond if the entity 

17 has already posted a surety bond for purposes 

18 of meeting such a bond requirement as a sup19 plier of durable medical equipment or other 

20 lines of business; or 

21 ‘‘(iii) to accept assignment on claims for 

22 home oxygen therapy services or to be a partici23 pating supplier with respect to such services. 

24 ‘‘(3) RETESTING PROCESS.— 


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1 ‘‘(A) IN GENERAL.—The Secretary shall estab2 lish a re-testing process that requires qualified home 

3 oxygen therapy providers to facilitate re-testing, in 

4 accordance with current standards of practice and 

5 regulations of the Secretary, of individuals furnished 

6 home oxygen therapy services between 60 and 120 

7 days of the date on which the services were initiated 

8 in the case of individuals who had a diagnosis for 

9 whom home oxygen therapy was prescribed for the 

10 first time. 

11 ‘‘(B) EXEMPTION.—Such re-testing process 

12 shall not apply to individuals whose diagnosis was 

13 for chronic respiratory disease, including for chronic 

14 conditions that typically require oxygen therapy for 

15 an extended period of time, such as chronic obstruc16 tive pulmonary disease, emphysema, obstructive 

17 chronic bronchitis, bronchiectasis, congestive heart 

18 failure, pulmonary fibrosis, obstructive sleep apnea, 

19 and Alpha-1 Antitrypsin Deficiency (A1AD).’’. 

20 (b) PAYMENT.—Section 1834 of such Act (42 U.S.C. 

21 1395m) is amended by adding at the end the following 

22 new subsection: 

23 ‘‘(n) PAYMENT FOR HOME OXYGEN THERAPY SERV24 ICES.— 


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1 ‘‘(1) ESTABLISHMENT OF SINGLE BUNDLED

2 PAYMENT SYSTEM.—Payment for home oxygen ther3 apy services under this part shall be based on a sin4 gle bundled payment rate for home oxygen therapy 

5 services (including equipment and supplies) deter6 mined under this subsection. Such a rate shall— 

7 ‘‘(A) be applied separately for each patient 

8 category established under paragraph (2); 

9 ‘‘(B) be paid on a per-patient-per-month 

10 basis; 

11 ‘‘(C) be initially computed under para12 graph (3) in a budget neutral manner based on 

13 allowed payments for providing such services 

14 (including equipment and supplies); 

15 ‘‘(D) be annually updated in accordance 

16 with paragraph (4); and 

17 ‘‘(E) be adjusted for its patient services 

18 component for geographic factors under para19 graph (5). 

20 ‘‘(2) PATIENT CATEGORIES.— 

21 ‘‘(A) IN GENERAL.—Under the single bun22 dled payment system, individuals receiving 

23 home oxygen therapy services shall be classified 

24 into one of three patient categories, as follows: 


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1 ‘‘(i) CATEGORY 1.—A first category of 

2 individuals (in this subsection referred to 

3 as ‘category 1’) who lack mobility or are 

4 prescribed oxygen for nocturnal use only. 

5 ‘‘(ii) CATEGORY 2.—A second category 

6 of individuals (in this subsection referred 

7 to as ‘category 2’) who have standard port8 ability needs for oxygen therapy. 

9 ‘‘(iii) CATEGORY 3.—A third category 

10 of individuals (in this subsection referred 

11 to as ‘category 3’) who have high port12 ability needs for oxygen therapy. 

13 ‘‘(B) DEFINITIONS.—In this paragraph: 

14 ‘‘(i) The term ‘standard portability’ 

15 means the use of portable oxygen is esti16 mated at less than or equal to 40 liter 

17 hours per week. 

18 ‘‘(ii) The term ‘high portability’ 

19 means the use of portable oxygen is esti20 mated at more than 40 liter hours per 

21 week. 

22 ‘‘(iii) The term ‘liter hours per week’ 

23 means the total liters of oxygen used dur24 ing a month divided by 4.3 (weeks per 


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1 month) divided by liters per minute pre2 scribed divided by 60 minutes. 

3 ‘‘(C) REQUIREMENT FOR ASSESSMENT.— 

4 ‘‘(i) IN GENERAL.—Subject to clause 

5 (ii), on and after January 1, 2010, an indi6 vidual may not be furnished home oxygen 

7 therapy services under this part unless a 

8 physician has assigned an individual into a 

9 patient category and indicated such assign10 ment on a certificate of medical need that 

11 is given to the home oxygen therapy pro12 vider. 

13 ‘‘(ii) GRANDFATHER.—In the case of 

14 an individual who is receiving home oxygen 

15 therapy as of January 1, 2010, for which 

16 payment is being made under this title, 

17 clause (i) shall not apply until January 1, 

18 2011, and until the date a physician as19 signs the individual into a patient category. 

20 Before such date, the individual shall be 

21 classified based on the individual’s pre22 scription as in effect on December 31, 

23 2009. 

24 ‘‘(3) INITIAL PAYMENT RATE.— 

25 ‘‘(A) IN GENERAL.— 


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1 ‘‘(i) The single bundled payment rate 

2 for 2010, 2011, and 2012 shall be com3 puted annually by the Secretary in a budg4 et neutral manner consistent with subpara5 graph (D) using the distributions for each 

6 category in clause (ii). The Secretary shall 

7 not make any prospective adjustments to 

8 the payment rates under this reimburse9 ment methodology for such years. The base 

10 year shall be the latest available calendar 

11 year adjusted data. 

12 ‘‘(ii) For 2010, 2011, and 2012, the 

13 Secretary shall establish the single bundled 

14 payment rate by assuming the following 

15 distribution of individuals among the cat16 egories: 

17 ‘‘(I) In category 1, 30 percent. 

18 ‘‘(II) In category 2, 50 percent. 

19 ‘‘(III) In category 3, 20 percent. 

20 The Secretary shall base the allowed pay21 ments for categories 1 and 3 upon a per22 centage relationship to the allowed pay23 ment for category 2. Category 3 allowed 

24 payment rate should be greater than cat25 egory 2 allowed payment rate and category 


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1 2 allowed payment rate should be greater 

2 than category 1. 

3 ‘‘(B) PAYMENTS FOR YEARS 2013 AND

4 2014.—The single bundled payment rates for 

5 2013 and 2014 shall be computed by the Sec6 retary in a budget neutral manner consistent 

7 with subparagraph (D) using data obtained 

8 through the cost reports required under this 

9 section. 

10 ‘‘(C) PAYMENTS FOR YEARS 2015 AND BE11 YOND.—The single bundled payment rates for 

12 2015 and subsequent years shall be computed 

13 by the Secretary using data obtained through 

14 the cost reports required under this section. 

15 ‘‘(D) BUDGET NEUTRALITY.—The Sec16 retary shall calculate the single bundled pay17 ment rates established under this section for 

18 2010, 2011, 2012, 2013, and 2014 such that 

19 the total spending for each year is equivalent in 

20 the aggregate to the spending that would have 

21 been made for home oxygen therapy during 

22 such year if the amendments made by the 

23 Medicare Home Oxygen Therapy Services Act 

24 of 2009 had not been enacted. 


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1 ‘‘(4) ANNUAL UPDATE BY CPI–U.—The pay2 ment rates established under this subsection shall be 

3 adjusted for each year (beginning with 2011) in a 

4 prospective manner by the Secretary and be pub5 lished by October 1 of the previous year based on 

6 the percentage increase in the consumer price index 

7 for all urban consumers (all items; U.S. city aver8 age) applicable to the year involved. 

9 ‘‘(5) APPLICATION OF GEOGRAPHIC ADJUST10 MENT.—The payment rates established under this 

11 subsection shall be adjusted, in a budget neutral 

12 manner, to take into account differences among 

13 areas in labor and transportation costs. 

14 ‘‘(6) INCLUDING PATIENT CATEGORY AND RE15 LATED INFORMATION ON CERTIFICATE OF MEDICAL

16 NEED.—The Secretary shall modify the certificate of 

17 medical need used under this part for home oxygen 

18 therapy services so that an individual’s physician 

19 would indicate on the form the appropriate patient 

20 category for the individual. Any change in an indi21 vidual’s category would be made by the physician 

22 submitting an updated certificate of medical need 

23 form indicating the change in the individual’s cat24 egory. 


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1 ‘‘(7) RESPONSIBILITIES OF QUALIFIED HOME

2 OXYGEN THERAPY PROVIDERS AND PHYSICIANS.— 

3 ‘‘(A) PROVIDERS.—A qualified home oxy4 gen therapy provider is responsible for moni5 toring and periodically re-evaluating, using the 

6 Oxygen Patient Evaluation Form, each indi7 vidual to whom the provider is furnishing home 

8 oxygen therapy services under this part and no9 tifying the prescribing physician when the re10 sults of such an re-evaluation indicate that a re11 assignment in a category under this subsection 

12 may be warranted due to a change in the indi13 vidual’s clinical condition or ambulatory status. 

14 ‘‘(B) PHYSICIANS.—Such an individual’s 

15 physician is responsible for making any change 

16 in such an individual’s category placement and 

17 for documenting such change in the individual’s 

18 medical record and providing an updated cer19 tificate of medical need to the home oxygen 

20 therapy provider. 

21 ‘‘(8) COST REPORTS.— 

22 ‘‘(A) IN GENERAL.—The Secretary in con23 sultation with the Home Oxygen Therapy Advi24 sory Committee established under paragraph 

25 (9) shall develop an annual cost report for 


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1 qualified home oxygen therapy providers with 

2 respect to the costs incurred for equipment, 

3 supplies, and services furnished to individuals. 

4 Qualified home oxygen therapy providers shall 

5 submit such report annually to the Secretary 

6 and the Secretary shall not require the submis7 sion of more than one such cost report for such 

8 a provider for each year. 

9 ‘‘(B) STREAMLINED REPORT FOR SMALL

10 SUPPLIERS.—Qualified home oxygen therapy 

11 providers with not more than $1,000,000 in 

12 revenue from the provision of home oxygen 

13 therapy services under this part shall be per14 mitted to submit a shorter or streamlined re15 port under this paragraph. 

16 ‘‘(C) IMPLEMENTATION.—The Secretary 

17 shall not require the submission of a cost report 

18 under this paragraph earlier than January 1, 

19 2012. 

20 ‘‘(9) HOME OXYGEN THERAPY ADVISORY COM21 MITTEE.— 

22 ‘‘(A) IN GENERAL.—The Secretary shall 

23 establish and convene an independent, multi24 disciplinary, nonpartisan Home Oxygen Ther25 apy Advisory Committee (in this paragraph reVerDate Nov 24 2008 04:46 Jul 16, 2009 Jkt 079200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H3220.IH H3220

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1 ferred to as the ‘Advisory Committee’) (pursu2 ant to section 222 of the Public Health Service 

3 Act (42 U.S.C. 217a)) not later than 6 months 

4 after the date of the enactment of this sub5 section. 

6 ‘‘(B) COMPOSITION.—The Advisory Com7 mittee shall consist of such members as the 

8 Secretary may appoint and who shall serve for 

9 such term as the Secretary may specify. In ap10 pointing members, the Secretary shall consult 

11 with the home oxygen therapy community. The 

12 Advisory Committee shall be comprised of mem13 bers of the home oxygen therapy community, 

14 including patients, nurses, respiratory thera15 pists, physicians, qualified home oxygen therapy 

16 providers representing urban and rural markets 

17 and the diverse provider community, public 

18 health organizations, patient advocates, and 

19 manufacturers. In this subparagraph, the term 

20 ‘public health organization’ means a private en21 tity and does not include a public health agen22 cy. 

23 ‘‘(C) FUNCTIONS.—The Committee shall 

24 provide a forum for expert discussion and delib25 eration and the formulation of advice and recVerDate Nov 24 2008 04:46 Jul 16, 2009 Jkt 079200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H3220.IH H3220

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1 ommendations to the Secretary regarding cov2 erage and payment for home oxygen therapy 

3 services under this part, including— 

4 ‘‘(i) selecting, modifying, and updat5 ing quality measures; 

6 ‘‘(ii) developing the objective, evi7 dence-based clinical criteria used to define 

8 each of the patient categories; 

9 ‘‘(iii) designing a consensus-based ox10 ygen patient evaluation form; 

11 ‘‘(iv) refining the services included in 

12 home oxygen therapy services; 

13 ‘‘(v) establishing a quality improve14 ment program; 

15 ‘‘(vi) evaluating a comparative effec16 tiveness program that also would also in17 clude chronic care management; and 

18 ‘‘(vii) strengthening anti-fraud, abuse, 

19 and waste provisions by— 

20 ‘‘(I) mandating site inspections 

21 for all new home oxygen therapy pro22 viders; 

23 ‘‘(II) requiring site inspections 

24 for all home oxygen therapy provider 

25 renewals; 


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1 ‘‘(III) improving validation of 

2 new home oxygen therapy providers 

3 by improving the application process 

4 for obtaining a National Provider 

5 Identifier; 

6 ‘‘(IV) requiring two additional 

7 random, unannounced site visits for 

8 all new home oxygen therapy pro9 viders during the first year of oper10 ation; 

11 ‘‘(V) requiring a 6-month trial 

12 period for new home oxygen therapy 

13 providers during which time the pro14 vider would receive a preliminary Na15 tional Provider Identifier; 

16 ‘‘(VI) establishing an anti-fraud 

17 office within the Centers for Medicare 

18 & Medicaid Services to coordinate de19 tection and deterrence of fraud and 

20 improper payments across the Medi21 care and Medicaid programs by ac22 cepting and responding to reports of 

23 alleged fraud and abuse from physi24 cians and providers; 


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1 ‘‘(VII) considering the proper 

2 Federal funding levels needed for im3 proving fraud prevention; 

4 ‘‘(VIII) requiring post-payment 

5 audit reviews for all new home oxygen 

6 therapy providers relying upon 6 

7 months’ worth of claims submissions; 

8 ‘‘(IX) requiring the Centers for 

9 Medicare & Medicaid Services to con10 duct real-time claims analysis ana11 lyzing home oxygen therapy provider 

12 claims to identify aberrant billing pat13 terns more quickly; 

14 ‘‘(X) ensuring that all providers 

15 are qualified to offer the services for 

16 which they submit claims by man17 dating cross-checking Medicare and 

18 other relevant databases to ensure 

19 that home oxygen therapy providers 

20 are qualified and accredited for pro21 viding home oxygen therapy services; 

22 ‘‘(XI) establishing written due 

23 process procedures for home oxygen 

24 therapy providers applying for a Na25 tional Provider Identifier, including 


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1 establishing an administrative appeals 

2 process and clear timelines; 

3 ‘‘(XII) increasing penalties and 

4 fines and fraud for activities such as 

5 buying or stealing beneficiaries’ Medi6 care numbers or physician’s provider 

7 numbers; and 

8 ‘‘(XIII) establishing more rig9 orous quality standards. 

10 ‘‘(D) REPORT.—The Committee shall pro11 vide the Secretary with periodic reports that 

12 summarize the Committee’s activities and its 

13 recommendations for such legislation and ad14 ministrative action as it considers appropriate. 

15 ‘‘(E) AUTHORIZATION OF APPROPRIA16 TIONS.—There are authorized to be appro17 priated such sums as may be necessary to carry 

18 out the purposes of this paragraph. 

19 ‘‘(10) CLAIMS PROCESSING.—The Secretary 

20 shall provide for processing of claims for home oxy21 gen therapy services from home oxygen therapy pro22 viders to be conducted through the administrative 

23 contractors under this title for durable medical 

24 equipment. 


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1 ‘‘(11) BENEFICIARY RIGHTS.—The Secretary 

2 shall establish through regulation the following pro3 tections for individuals receiving home oxygen ther4 apy services under this part: 

5 ‘‘(A) To choose the individual’s local pro6 vider of such services from among qualified 

7 home oxygen therapy service providers and to 

8 change such provider. 

9 ‘‘(B) To receive communications from the 

10 home oxygen therapy provider in a clear and 

11 understandable manner. 

12 ‘‘(C) To privacy and confidentiality in all 

13 aspects of treatment and their personal health 

14 information consistent with Federal and State 

15 laws. 

16 ‘‘(D) To be informed by the home oxygen 

17 therapy provider about and participate, if de18 sired, in all aspects of the oxygen therapy serv19 ices being furnished to the individual by the 

20 provider, and be informed by such provider of 

21 the right to refuse treatment, to discontinue 

22 treatment, and to refuse to participate in exper23 imental research. 

24 ‘‘(E) To be informed by the home oxygen 

25 therapy provider of policies and expectations of 


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1 the provider regarding patient conduct and re2 sponsibilities. 

3 ‘‘(F) To be informed by the home oxygen 

4 therapy provider about the individual’s right to 

5 execute advance directives. 

6 ‘‘(G) To be informed by the home oxygen 

7 therapy provider about treatment modalities 

8 and categories of equipment relating to home 

9 oxygen therapy services for use by the indi10 vidual and offered by the provider. 

11 ‘‘(H) To be informed of the home oxygen 

12 therapy provider’s policies regarding 24-hour 

13 on-call coverage. 

14 ‘‘(I) To be informed by the home oxygen 

15 therapy provider of the individual’s financial re16 sponsibilities with regard to such services. 

17 ‘‘(J) To be provided with the clinically ap18 propriate oxygen equipment and services as 

19 agreed upon by the individual (or the individ20 ual’s representative), the provider, and the pre21 scribing physician. 

22 ‘‘(K) To be informed by the home oxygen 

23 therapy provider of any potential changes to the 

24 individual’s equipment or services regarding 

25 home oxygen therapy services and the right to 


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1 consult with individual’s physician regarding 

2 such changes to ensure they are appropriate 

3 and necessary and the exceptions as specified 

4 by the Secretary when a home oxygen therapy 

5 provider may change an individual’s oxygen 

6 equipment. 

7 ‘‘(L) To be informed by the home oxygen 

8 therapy provider of the provider’s internal and 

9 external grievance processes (as well as how to 

10 contact Medicare through the hotline or Bene11 ficiary Ombudsman), including the individual’s 

12 right to file internal or external grievances or 

13 both without retaliation or denial of services 

14 and the right to file them personally or through 

15 a representative of the individual’s choosing. 

16 ‘‘(M) To receive from the home oxygen 

17 therapy provider written notice 30 days in ad18 vance of an involuntary termination, after the 

19 home oxygen therapy provider follows estab20 lished involuntary discharge procedures; how21 ever, in the case of immediate threats to the 

22 health and safety of others, the Secretary may 

23 permit the home oxygen therapy provider to use 

24 an abbreviated termination procedure. 


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1 ‘‘(N) To be assisted by the home oxygen 

2 therapy provider in obtaining the equipment 

3 and supplies for home oxygen therapy services 

4 prescribed by individual’s treating physician 

5 when the individual is traveling. 

6 ‘‘(O) To receive from the home oxygen 

7 therapy provider oxygen supplies, refills, and 

8 emergency back-up equipment and refills as ap9 propriate.’’. 

10 SEC. 4. EFFECTIVE DATE. 

11 The amendments made by this Act shall apply to 

12 services and supplies furnished on or after January 1, 

13 2010. 

Æ 


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