cludes evaluating the environment of the 
beneficiary for safety risks or hazards, 
such as fire and fall hazards; 
‘‘(iv) providing appropriate delivery, 
set-up, and coordination of oxygen services 
(including the delivery of any oxygen 
equipment or supplies to a beneficiary 
prior to such beneficiary being discharged, 
delivering such equipment, and setting up 
the equipment), as needed, in a timely 
manner as agreed upon by the beneficiary 
or caregiver, supplier, and prescribing 
practitioner; 
‘‘(v) evaluating the ability of the bene-
ficiary to operate the equipment safely and 
effectively; 
‘‘(vi) providing infection control infor-
mation and instructions about all equip-
ment and supplies; 
‘‘(vii) 
providing 
equipment-related 
services, including checking oxygen system 
purity levels and flow rates, changing and 
cleaning filters, and assuring the integrity 
of alarms and back-up systems, consistent 
with the manufacturer specifications and 
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in accordance with all Federal, State, and 
local laws and regulations; 
‘‘(viii) monitoring visits when nec-
essary by appropriate personnel, including 
a respiratory therapist to evaluate all as-
pects of the services being provided to the 
beneficiary by the provider; 
‘‘(ix) documenting exception reporting 
by the supplier to the prescribing physician 
when changes occur in the compliance of 
the beneficiary with the beneficiary’s plan 
of care; 
‘‘(x) providing, as needed, continued 
education to the beneficiary or caregiver 
regarding appropriate oxygen equipment 
maintenance practices and performance; 
‘‘(xi) providing, as prescribed by the 
plan of care of the prescribing practitioner, 
appropriate oxygen and oxygen related 
equipment, supplies, and services (includ-
ing supplemental supplies and emergency 
oxygen back-ups as appropriate); 
‘‘(xii) ensuring oxygen and oxygen 
equipment can be used appropriately out-
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side the home of a beneficiary based on ne-
cessity; 
‘‘(xiii) providing 24-hour on-call cov-
erage to respond to beneficiary needs relat-
ing to oxygen and oxygen related equip-
ment, supplies, and services; and 
‘‘(xiv) assisting the beneficiary with 
the coordination of oxygen and oxygen re-
lated equipment, supplies, and services, in-
cluding by assisting the beneficiary find a 
different supplier if the beneficiary tempo-
rarily travels outside of the service area of 
the supplier. If the beneficiary relocates 
permanently, the new supplier caring for 
the beneficiary will assume responsibility 
for billing the Medicare program directly.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall take effect on the date that is 1 year 
after the date of enactment of this Act. 
SEC. 103. TECHNICAL CORRECTIONS. 
Section 1861(n) is amended by striking ‘‘iron lungs, 
oxygen tents’’ and inserting ‘‘oxygen and oxygen related 
equipment, supplies, and services’’. 
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TITLE 
II—PROTECTING 
BENE-
FICIARY 
ACCESS 
TO 
RES-
PIRATORY THERAPISTS 
SEC. 201. REIMBURSEMENT FOR RESPIRATORY THERA-
PISTS. 
(a) PROTECTING ACCESS TO RESPIRATORY THERA-
PIST SERVICES.— 
(1) ADDING
RESPIRATORY
THERAPIST
SERV-
ICES TO THE DEFINITION OF MEDICAL AND OTHER 
HEALTH SERVICES.—Section 1861(s)(2) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)) is amend-
ed— 
(A) in subparagraph (JJ), by inserting 
‘‘and’’ after the semicolon; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(KK) respiratory therapist services (as 
defined in subsection (nnn)) furnished on or 
after January 1, 2025.’’. 
(2) DEFINITION OF RESPIRATORY THERAPIST 
SERVICES.—Section 1861 of the Social Security Act 
(42 U.S.C. 1395x) is amended by adding at the end 
the following new subsection: 
‘‘(nnn) RESPIRATORY THERAPIST SERVICES.—The 
term ‘respiratory therapist services’ means services per-
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formed by a respiratory therapist within the scope of prac-
tice of a respiratory therapist as defined by State law, reg-
ulations, and applicable accreditation standards for the as-
sessment, treatment, and monitoring of patients requiring 
oxygen and oxygen related equipment, supplies, or serv-
ices.’’. 
(b) 
ADD-ON
PAYMENT
ADJUSTMENT.—Section 
1834(a)(9) of the Social Security Act (42 U.S.C. 
1395m(a)(9)), as amended by sections 101(b) and 102(a), 
is further amended by adding at the end the following new 
subparagraph: 
‘‘(H) MONTHLY
PAYMENT
ADD-ON
AD-
JUSTMENT FOR RESPIRATORY THERAPIST SERV-
ICES.—For respiratory therapist services fur-
nished on or after January 1, 2025, the Sec-
retary shall implement through notice and com-
ment rulemaking and in consultation with 
stakeholders a non-budget neutral add-on pay-
ment adjustment to the payment amount estab-
lished under this paragraph that reflects the 
cost of providing respiratory therapist services 
as clinically appropriate under State law.’’. 
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TITLE III—ADOPTION OF 
ELECTRONIC TEMPLATES 
SEC. 301. USE OF ELECTRONIC TEMPLATES TO DOCUMENT 
MEDICAL NECESSITY AND RESTORING CLIN-
ICAL INFERENCE FOR OXYGEN AND OXYGEN 
RELATED EQUIPMENT, SUPPLIES, AND SERV-
ICES. 
(a) ADOPTING ELECTRONIC TEMPLATES FOR DE-
TERMINING MEDICAL NECESSITY.—Section 1834(a)(5) of 
the Social Security Act (42 U.S.C. 1395m(a)(5)) is 
amended by adding at the end the following: 
‘‘(G) ADOPTION
OF
ELECTRONIC
TEM-
PLATES TO DOCUMENT MEDICAL NECESSITY.— 
‘‘(i) IN
GENERAL.—For any oxygen 
and oxygen related equipment, supplies or 
service, including liquid oxygen, furnished 
on or after January 1, 2025, the Secretary 
shall adopt a template in an electronic for-
mat that meets the requirements of clause 
(ii) to be completed by the prescribing 
practitioner (as defined by the Secretary) 
that shall constitute the complete request 
for information to determine whether pay-
ment for such service, equipment, or sup-
plies is covered by this title and is reason-
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able and necessary for the diagnosis or 
treatment of illness or injury (under sec-
tion 1862(a)(1)(A)). 
‘‘(ii) TEMPLATE
REQUIREMENTS.— 
The template shall require the prescribing 
practitioner to provide each of the fol-
lowing: 
‘‘(I) Documentation that the ben-
eficiary was seen by a prescribing 
practitioner within the appropriate 
timeframes for certification of the 
need for the services, equipment, or 
supplies. 
‘‘(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 
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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 
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.’’. 
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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: 
‘‘(I) ESTABLISHING PROTECTIONS FOR IN-
DIVIDUALS RECEIVING OXYGEN OR OXYGEN RE-
LATED EQUIPMENT, SUPPLIES, OR SERVICES.— 
The Secretary shall establish through regulation 
protections for any individual receiving oxygen 
or oxygen related equipment, supplies, or serv-
ices under this part where such individual 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 
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personal health information of such indi-
vidual consistent with Federal and State 
laws; 
‘‘(iv) be informed by the supplier of 
such services about all aspects of the serv-
ices being furnished by such supplier and 
be informed of the right to refuse treat-
ment, to discontinue treatment, and to 
refuse to participate in experimental re-
search; 
‘‘(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; 
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‘‘(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 
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) be informed by the supplier of 
any potential changes to the equipment, 
supplies, or services of the individual and 
the right to consult with the prescribing 
practitioner of the individual regarding 
such changes to ensure they are appro-
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priate and necessary and to be informed of 
the exceptions, as specified by the Sec-
retary, when a supplemental oxygen serv-
ices supplier may change the oxygen equip-
ment of the individual; 
‘‘(xiv) be informed by the supplier of 
the internal and external grievance proc-
esses of the supplier (as well as how to 
contact Medicare through a hotline or ben-
eficiary ombudsman), which shall include 
the right of an individual to file, personally 
or through a representative of the individ-
ual’s choosing, an internal or external 
grievance without retaliation or denial of 
services; 
‘‘(xv) 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— 
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‘‘(aa) follow established in-
voluntary discharge procedures; 
or 
‘‘(bb) in the case of an im-
mediate threat to the health and 
safety of others, follow an abbre-
viated involuntary discharge pro-
cedure; 
‘‘(xvi) 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; 
‘‘(xvii) receive from the supplier oxy-
gen supplies, refills, and emergency back- 
up equipment, as appropriate; and 
‘‘(xviii) 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.’’. 
Æ 
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