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 subse-
quently 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Home Oxy-
gen Therapy Act of 2009’’. 
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SEC. 2. TREATMENT OF HOME OXYGEN THERAPY SEPA-
RATE FROM DURABLE MEDICAL EQUIPMENT. 
(a) ELIMINATION FROM DEFINITION OF DURABLE 
MEDICAL EQUIPMENT.—Section 1861(n) of the Social Se-
curity Act (42 U.S.C. 1395x(n)) is amended— 
(1) by striking ‘‘oxygen tents,’’; and 
(2) by adding at the end the following new sen-
tence: ‘‘Such term does not include oxygen and home 
oxygen therapy services.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 1834(a) of the Social Security Act 
(42 U.S.C. 1395m(a)) is amended— 
(A) by striking paragraphs (5) and (9); 
(B) in paragraph (6), by striking ‘‘(4), or 
(5)’’ and inserting ‘‘or (4)’’; and 
(C) in paragraph (21)(B), by striking ‘‘ox-
ygen and oxygen equipment,’’. 
(2) Section 1847(a) of such Act (42 U.S.C. 
1395w–3(a)) is amended— 
(A) in paragraph (1)(D)(i)— 
(i) in subclause (II), by striking ‘‘and 
(IV)’’ and inserting ‘‘, (IV), and (V)’’; 
(ii) by striking ‘‘and’’ at the end of 
subclause (III); 
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(iii) by striking the period at the end 
of subclause (IV) and inserting ‘‘; and’’; 
and 
(iv) by adding at the end the following 
new subclause: 
‘‘(V) the Secretary shall exclude 
oxygen and oxygen equipment.’’; 
(B) in paragraph (2), by inserting ‘‘(and 
do not include oxygen and oxygen equipment)’’ 
after ‘‘are the following’’; and 
(C) in paragraph (4)— 
(i) by striking ‘‘AND OXYGEN’’ in the 
heading; 
(ii) by striking ‘‘and in the case of 
payment 
for 
oxygen 
under 
section 
1834(a)(5)’’; and 
(iii) by striking ‘‘and supply arrange-
ments with oxygen suppliers’’. 
SEC. 3. COVERAGE OF HOME OXYGEN THERAPY SERVICES. 
(a) DEFINITIONS.—Section 1861 of the Social Secu-
rity Act is amended by adding at the end the following 
new subsection: 
‘‘Home Oxygen Therapy Services 
‘‘(hhh)(1) IN GENERAL.—The term ‘home oxygen 
therapy services’ means services and supplies furnished by 
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a qualified home oxygen therapy provider and includes, 
with respect to an individual, the following furnished by 
home oxygen therapy provider (as defined in paragraph 
(2)). 
‘‘(A) Conducting an initial evaluation of the in-
dividual using a uniform Oxygen Patient Evaluation 
Form developed, in consultation with the Home Oxy-
gen Therapy Advisory Committee, by the Secretary. 
‘‘(B) Providing written and verbal individual 
and caregiver education about home oxygen therapy, 
stationary and portable oxygen therapy options, and 
oxygen safety (such as evaluating the home environ-
ment for safety risks or hazards, including home fire 
and fall prevention). 
‘‘(C) Providing appropriate delivery, set-up, and 
coordination of oxygen (such as delivery of oxygen 
technology to hospital prior to discharge, delivery 
and set-up of equipment in the home), as needed, in 
a timely manner as agreed upon by the individual or 
caregiver (or both), the home oxygen therapy pro-
vider, and the physician. 
‘‘(D) Evaluating the individual’s ability to oper-
ate the oxygen equipment safely and effectively. 
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‘‘(E) Educating and, when necessary, providing 
assistance with infection control, focusing on keeping 
oxygen equipment from leading to infection. 
‘‘(F) Providing equipment-related services con-
sistent with the manufacturer specifications and in 
accordance with all Federal, State, and local laws 
and regulations, which may include checking oxygen 
system purity levels and flow rates, changing and 
cleaning filters, and assuring the integrity of alarms 
and back-up systems. 
‘‘(G) Monitoring visits by appropriately trained 
personnel to evaluate all aspects of the services 
being provided to the individual by the home oxygen 
therapy provider, including ensuring that individual 
is following the prescribed plan of care. 
‘‘(H) Documenting exception reporting by the 
home oxygen therapy provider when changes occur 
in the individual’s compliance with the plan of care 
to the prescribing physician. 
‘‘(I) Providing, as needed, continued education 
regarding appropriate home oxygen equipment main-
tenance practices and performance by the individual 
and caregivers. 
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