‘‘(II) Documentation of the quali-
fying blood gas or saturation test re-
sults. 
‘‘(III) Documentation indicating 
that the beneficiary needs or is using 
the appropriate equipment, supplies, 
and services. 
‘‘(IV) Any other documentation 
determined appropriate by the Sec-
retary, except the Secretary shall not 
require the prescribing practitioner to 
provide medical record notes regard-
ing the beneficiary. 
‘‘(iii) CONTRACTOR ADJUDICATION.— 
The Secretary shall require Medicare ad-
ministrative 
contractors 
to 
adjudicate 
claims for payment for oxygen and oxygen 
related equipment, supplies, and services 
using electronic transactions. 
‘‘(H) RESTORATION OF CLINICAL INFER-
ENCE AND JUDGMENT.—For claims submitted 
on or after the date of enactment of this sub-
paragraph with respect to the conduct of pay-
ment audits of suppliers of oxygen and oxygen 
related equipment, supplies, and services under 
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this part the Secretary shall use clinical infer-
ence and clinical judgment in the evaluation of 
templates, medical records, and orders when 
conducting such audits in the same manner as 
the Secretary interpreted and applied such clin-
ical judgment to claim reviews before 2009 pur-
suant to the Secretary’s instruction to contrac-
tors.’’. 
SEC. 302. ESTABLISHING NOTICE REQUIREMENTS FOR IN-
DIVIDUALS RECEIVING OXYGEN OR OXYGEN 
RELATED EQUIPMENT, SUPPLIES, OR SERV-
ICES. 
(a) ANNUAL NOTICE
OF COST-SHARING OBLIGA-
TIONS FOR SUPPLEMENTAL OXYGEN.—Section 1804 of 
the Social Security Act (42 U.S.C. 1395b–2) is amended 
by adding at the end the following new subsection: 
‘‘(e) The notice provided under subsection (a) shall 
include— 
‘‘(1) a description of— 
‘‘(A) the 36-month rental period for sup-
plemental oxygen equipment under section 
1834(a)(5)(F); 
‘‘(B) the right of a beneficiary to discuss 
their prescription for supplemental oxygen 
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equipment with their prescribing physician or 
practitioner; and 
‘‘(C) any cost sharing requirements for 
supplemental oxygen equipment, supplies, and 
services under this title and the termination of 
such requirements when a beneficiary refuses or 
discontinues supplemental oxygen therapy; and 
‘‘(2) information on the internal and external 
grievance processes of suppliers of oxygen and oxy-
gen related equipment, supplies, and services under 
this title (as well as how to contact Medicare 
through a hotline or beneficiary ombudsman), in-
cluding the right of a beneficiary to file, personally 
or through a representative of the beneficiary’s 
choosing, an internal or external grievance without 
retaliation or denial of services from a supplier.’’. 
(b) TIMELY NOTICE OF END OF COST-SHARING OB-
LIGATIONS
FOR
SUPPLEMENTAL
OXYGEN.—Section 
1834(a)(5)(F) of the Social Security Act (42 U.S.C. 
1395m(a)(5)(F)), is amended by adding at the end the 
following new clause: 
‘‘(iii) TIMELY
NOTICE
OF
END
OF 
COST-SHARING OBLIGATIONS FOR SUPPLE-
MENTAL OXYGEN.—The Secretary, in con-
sultation with patient advocates, physi-
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cians, supplemental oxygen suppliers, res-
piratory therapists, and other stakeholders, 
shall distribute a monthly notice to each 
individual receiving supplemental oxygen 
equipment, supplies, and services stating 
the number of months remaining within 
the rental cap period under this subpara-
graph during which the beneficiary is re-
sponsible for the copayment amount for 
such equipment.’’. 
TITLE IV—ESTABLISHMENT OF 
BENEFICIARY RIGHTS 
SEC. 401. ESTABLISHING PROTECTIONS FOR INDIVIDUALS 
RECEIVING OXYGEN OR OXYGEN RELATED 
EQUIPMENT, SUPPLIES, OR SERVICES. 
Section 1834(a)(5) of the Social Security Act (42 
U.S.C. 1395m(a)(5)), as amended by section 301, is fur-
ther amended by adding at the end the following new sub-
paragraph: 
‘‘(H) ESTABLISHING
PROTECTIONS
FOR 
INDIVIDUALS RECEIVING OXYGEN OR OXYGEN 
RELATED
EQUIPMENT, SUPPLIES, OR
SERV-
ICES.—The Secretary shall establish through 
regulation protections for any individual receiv-
ing oxygen or oxygen related equipment, sup-
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plies, or services under this part where such in-
dividual shall have the right to— 
‘‘(i) choose the local supplier of such 
services from among qualified suppliers 
and to change such supplier; 
‘‘(ii) receive communications from the 
supplier in a clear and understandable 
manner; 
‘‘(iii) ensure privacy and confiden-
tiality in all aspects of treatment and the 
personal health information of such indi-
vidual consistent with Federal and State 
laws; 
‘‘(iv) be informed by the supplier of 
such services regarding— 
‘‘(I) all aspects of the services 
being furnished by such supplier; 
‘‘(II) the right to refuse treat-
ment and to discontinue treatment, 
including informing the individual’s 
physician and indicating when indi-
vidual cost-sharing requirements end; 
and 
‘‘(III) the right to refuse to par-
ticipate in experimental research; 
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‘‘(v) be informed by the supplier of 
policies and expectations of the supplier re-
garding patient conduct and responsibil-
ities; 
‘‘(vi) be informed by the supplier 
about treatment modalities and categories 
of equipment relating to oxygen services 
for use by the individual and offered by the 
supplier; 
‘‘(vii) be informed by the supplier of 
the policies of such supplier regarding 24- 
hour on-call coverage; 
‘‘(viii) be informed by the supplier of 
the financial responsibilities of the indi-
vidual with regard to such services, includ-
ing the number of months remaining with-
in the rental cap period under subpara-
graph (F) during which the patient is re-
sponsible for the copayment amount; 
‘‘(ix) be provided with the appropriate 
gaseous or liquid oxygen equipment, sup-
plies, and services to ensure the mobility of 
the beneficiary, as well as the clinically ap-
propriate amount of oxygen and oxygen re-
lated equipment, supplies, and services as 
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agreed upon by the individual (or the indi-
vidual’s representative), the supplier, and 
the prescribing practitioner; 
‘‘(x) receive equipment that is main-
tained to the guidelines of the manufac-
turer; 
‘‘(xi) have broken or faulty equipment 
repaired or replaced in a timely manner; 
‘‘(xii) have oxygen or oxygen related 
equipment or supplies delivered by the sup-
plier and to be contacted consistent with 
the requirements of section 410.38 of title 
42, Code of Federal Regulations; 
‘‘(xiii) in the case of a supplier invol-
untary discharging an individual— 
‘‘(I) receive from such supplier a 
written notice that is provided to the 
individual no later than 30 days in 
advance of the involuntary discharge 
of the individual; and 
‘‘(II) have such supplier— 
‘‘(aa) follow established in-
voluntary discharge procedures; 
or 
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‘‘(bb) in the case of an im-
mediate threat to the health and 
safety of others, follow an abbre-
viated involuntary discharge pro-
cedure; 
‘‘(xiv) be assisted by the supplier in 
obtaining the oxygen equipment and sup-
plies prescribed by the treating physician 
of the individual when the individual is 
traveling; 
‘‘(xv) receive from the supplier oxygen 
supplies, refills, and emergency back-up 
equipment, as appropriate; 
‘‘(xvi) be informed of a plan by the 
supplier in case of a power outage or other 
natural emergency, so that the individual 
will continue to receive the necessary oxy-
gen supplies and equipment; and 
‘‘(xvii) be informed by the supplier 
of— 
‘‘(I) any potential changes to the 
equipment, supplies, or services being 
furnished to the individual and the 
right to consult with the prescribing 
physician or practitioner regarding 
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such changes to ensure they are ap-
propriate and necessary and to be in-
formed of the exceptions, as specified 
by the Secretary, when a supple-
mental oxygen services supplier may 
change the oxygen equipment of the 
individual; and 
‘‘(II) the internal and external 
grievance processes of the supplier (as 
well as how to contact Medicare 
through a hotline or beneficiary om-
budsman), which shall include the 
right of an individual to file, person-
ally or through a representative of the 
individual’s choosing, an internal or 
external grievance without retaliation 
or denial of services from such sup-
plier.’’. 
Æ 
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