I 
118TH CONGRESS 
2D SESSION 
H. R. 7829 
To amend title XVIII of the Social Security Act to improve the payment 
method for oxygen and oxygen related equipment, supplies, and services, 
to increase beneficiary access to oxygen and oxygen related equipment, 
supplies, and services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 26, 2024 
Mr. VALADAO (for himself, Mr. BUCSHON, Mr. SMITH of Nebraska, and Ms. 
BROWNLEY) introduced the following bill; which was referred to the Com-
mittee 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 improve 
the payment method for oxygen and oxygen related 
equipment, supplies, and services, to increase beneficiary 
access to oxygen and oxygen related equipment, supplies, 
and services, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Supplemental Oxygen Access Reform Act of 2024’’ or the 
‘‘SOAR Act of 2024’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—PROTECT BENEFICIARY ACCESS TO SUPPLEMENTAL 
OXYGEN THERAPY IN THE HOME AND COMMUNITY 
Sec. 101. Reform of the Medicare supplemental oxygen benefit. 
Sec. 102. Establishment of supplemental oxygen responsibilities criteria. 
Sec. 103. Technical corrections. 
TITLE II—PROTECTING BENEFICIARY ACCESS TO RESPIRATORY 
THERAPISTS 
Sec. 201. Reimbursement for respiratory therapists. 
TITLE III—ADOPTION OF ELECTRONIC TEMPLATES 
Sec. 301. Use of electronic templates to document medical necessity and restor-
ing clinical inference for oxygen and oxygen related equipment, 
supplies, and services. 
TITLE IV—ESTABLISHMENT OF BENEFICIARY RIGHTS 
Sec. 401. Establishing protections for individuals receiving oxygen or oxygen re-
lated equipment, supplies, or services. 
TITLE 
I—PROTECT 
BENE-
FICIARY ACCESS TO SUPPLE-
MENTAL 
OXYGEN 
THERAPY 
IN THE HOME AND COMMU-
NITY 
SEC. 101. REFORM OF THE MEDICARE SUPPLEMENTAL OX-
YGEN BENEFIT. 
(a) REMOVING OXYGEN
AND OXYGEN RELATED 
EQUIPMENT, SUPPLIES, AND SERVICES FROM COMPETI-
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TIVE ACQUISITION PROGRAM TO IMPROVE PATIENT AC-
CESS
TO SUPPLEMENTAL OXYGEN THERAPY.—Section 
1847(a)(3) of the Social Security Act (42 U.S.C. 1395w– 
3(a)(3)) is amended by— 
(1) inserting ‘‘AND EXCLUSION’’ after ‘‘EXCEP-
TION AUTHORITY’’; 
(2) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii), respectively, and moving 
such clauses as so redesignated 2 ems to the right; 
(3) by striking ‘‘In carrying out’’ and inserting 
the following: 
‘‘(A) IN GENERAL.—In carrying out’’; and 
(4) by adding at the end the following new sub-
paragraph: 
‘‘(B) EXCLUSION OF OXYGEN, AND OXY-
GEN
RELATED
EQUIPMENT, SUPPLIES, AND 
SERVICES.—Beginning on or after January 1, 
2025, the Secretary shall exclude oxygen and 
oxygen related equipment, supplies, and services 
from the competitive acquisition program under 
this section and payment for oxygen and oxygen 
related equipment, supplies, and services shall 
be made as prescribed under subparagraphs 
(E), (F). and (H) of section 1834(a)(9).’’. 
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(b) ESTABLISHING ADEQUATE PAYMENT FOR OXY-
GEN AND OXYGEN RELATED EQUIPMENT, SUPPLIES, AND 
SERVICES.—Section 1834(a)(9) of the Social Security Act 
(42 U.S.C. 1395m(a)(9)) is amended— 
(1) in the first sentence of the matter preceding 
subparagraph (A), by inserting the following before 
the period: ‘‘(for oxygen and oxygen equipment fur-
nished before January 1, 2025) or the amount de-
termined under subparagraph (E), subject to sub-
paragraphs (F), (G), and (H) (for oxygen and oxy-
gen related equipment, supplies, and services fur-
nished on or after January 1, 2025);’’; and 
(2) by adding at the end the following: 
‘‘(E) PAYMENT FOR OXYGEN AND OXYGEN 
RELATED
EQUIPMENT, SUPPLIES, AND
SERV-
ICES EXCLUDED FROM COMPETITIVE ACQUISI-
TION
PROGRAM.—Subject to subparagraphs 
(F), (G), and (H) in the case of oxygen and ox-
ygen related equipment, supplies, and services 
furnished on or after January 1, 2025— 
‘‘(i) in areas that are competitive bid-
ding areas in which a competitive bidding 
program is implemented for other covered 
items, the payment amount is equal to— 
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paragraph (5)(C), not later than Jan-
uary 1, 2025, the Secretary in con-
sultation with suppliers, manufactur-
ers, patients and patient advocates, 
and physicians, and through notice- 
and-comment rulemaking, shall estab-
lish a separate payment amount that 
meets the requirements of this sub-
paragraph made to a supplier for the 
provision of liquid oxygen and liquid 
oxygen related equipment, supplies, 
and services that meets the require-
ments described in subparagraph (G). 
‘‘(II) 
PAYMENT
FLOOR.—The 
payment amount established under 
subclause (I) may not be less than an 
amount equal to 200 percent of the 
2015 Durable Medical Equipment, 
Prosthetics/Orthotics & Supplies Fee 
Schedule updated by the consumer 
price index for all urban consumers 
(United States city average) for years 
2016 through 2024. 
‘‘(III) UPDATE
MECHANISM.— 
Beginning on January 1, 2026, the 
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payment amount described in sub-
clause (I) shall be increased annually 
by the projected percentage increase 
in the consumer price index for all 
urban consumers (United States city 
average) for the 12-month period end-
ing December 31 of the previous year. 
‘‘(ii) 
CONSIDERATIONS.—In 
imple-
menting the payment amount under this 
subparagraph, the Secretary shall take into 
account the cost of liquid oxygen on a per 
pound basis, the cost of liquid oxygen 
equipment, the infrastructure costs associ-
ated with providing liquid oxygen equip-
ment and supplies (including labor, stor-
age, 
transportation, 
maintenance, 
and 
similar costs), the cost of complying with 
Federal and State regulations specific to 
the delivery and transportation of liquid 
oxygen, and any other cost factors the Sec-
retary deems appropriate after consulting 
with stakeholders such as suppliers, pro-
viders, patients and patient advocates, and 
manufacturers. 
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‘‘(iii) MONTHLY
ADD-ON
FOR
HIGH- 
FLOW PATIENTS.— 
‘‘(I) IN
GENERAL.—Subject to 
subclause (II), the Secretary shall es-
tablish a non-budget neutral add-on to 
the payment amount under clause (i) 
when the prescribing practitioner or-
ders an oxygen flow rate equal to or 
greater than 6 liters per minute. 
‘‘(II) 
ADD-ON
AMOUNT.—The 
add-on amount shall equal the per 
pound cost of the oxygen exceeding 
the amount required to provide a liter 
flow that is equal to or greater than 
6 liters per minute. 
‘‘(iv) PERIODIC ASSESSMENT OF THE 
BASE RATE.—The Secretary shall assess at 
least once every 3 years the adequacy of 
the payment amounts under this subpara-
graph on a cost-related basis or other eco-
nomical and equitable basis. 
‘‘(v) TRANSITIONAL
INTERIM
PAY-
MENT.— 
‘‘(I) IN
GENERAL.—For items 
and services furnished on or after the 
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date of the enactment of the SOAR 
Act of 2024 and prior to the imple-
mentation of the payment amount es-
tablished under this subparagraph, 
the Secretary shall adopt a transi-
tional interim payment amount for 
liquid oxygen, and liquid oxygen 
equipment, supplies, and services in 
an amount equal to 200 percent of 
the 2015 Durable Medical Equipment, 
Prosthetics/Orthotics & Supplies Fee 
Schedule updated by the consumer 
price index for all urban consumers 
(United States city average) for years 
2016 through 2024. 
‘‘(II) 
UPDATE.—This 
amount 
shall be updated annually by the pro-
jected percentage change in the con-
sumer price index for all urban con-
sumers (United States city average) 
for the 12-month period ending on 
December 31 of the previous year, 
until the Secretary implements the 
payment amount under this subpara-
graph. 
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‘‘(vi) COVERAGE CRITERIA.— 
‘‘(I) IN
GENERAL.—Not later 
than January 1, 2025, the Secretary, 
in consultation with stakeholders, 
shall establish objective clinical cri-
teria for the coverage of liquid oxygen, 
and liquid oxygen equipment, supplies, 
and services under this title. 
‘‘(II) UPDATE
OF
CRITERIA.— 
The Secretary shall review and update 
the coverage standards under this 
clause every 5 years to ensure the 
standards take into consideration cur-
rent medical and clinical guidelines 
and take into effect modality in order 
to maximize beneficiary independ-
ence.’’. 
SEC. 102. ESTABLISHMENT OF SUPPLEMENTAL OXYGEN RE-
SPONSIBILITIES CRITERIA. 
(a) IN GENERAL.—1834(a)(9) of the Social Security 
Act (42 U.S.C. 1395m(a)(9)), as amended by section 
101(b), is further amended by inserting the following new 
subparagraph: 
‘‘(G) OXYGEN
AND
OXYGEN
RELATED 
EQUIPMENT, 
SUPPLIES, 
AND
SERVICES.—In 
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consultation with stakeholders, the Secretary 
shall define the scope of services a supplier of 
oxygen and oxygen related equipment, supplies, 
and services must provide to receive payment 
under this part, to include— 
‘‘(i) conducting an initial evaluation of 
the beneficiary using the uniform oxygen 
patient evaluation form described in para-
graph (5)(G) to determine the appropriate 
use of oxygen and oxygen related equip-
ment, supplies, and services by the bene-
ficiary, including the use of portable equip-
ment; 
‘‘(ii) ensuring the beneficiary has ap-
propriate access to portable oxygen, and 
portable oxygen equipment, supplies, and 
services based on the mobility needs of the 
beneficiary, including the needs of the ben-
eficiary outside the home of the bene-
ficiary; 
‘‘(iii) providing written and verbal 
beneficiary and caregiver education regard-
ing oxygen and oxygen related equipment, 
supplies, and services, stationary and port-
able options, and oxygen safety, which in-
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