Sponsors (60)
Introduced April 10, 2025 by David G. Valadao · Last progress April 10, 2025
The bill strengthens safety, patient rights, and clinical services for Medicare oxygen users and creates more predictable payments, but it raises Medicare spending and compliance costs that could increase out-of-pocket costs and strain supplier availability—especially in rural areas.
Medicare beneficiaries who use supplemental oxygen get standardized, predictable payments under the DME fee schedule (with CPI-U updates) and a higher transitional/floor payment for liquid oxygen to help preserve service availability during transition.
Medicare recipients on oxygen benefit from stronger supplier service requirements (evaluation, training, monitoring, timely delivery, 24-hour on-call, manufacturer maintenance and emergency backup plans), improving safety and continuity of care.
Medicare will cover respiratory therapist services for oxygen-related care (with a monthly add-on payment), formally recognizing RTs and improving access to assessment, treatment, and monitoring for beneficiaries on oxygen.
Removing oxygen from the competitive acquisition program and establishing higher payment floors/add-ons will increase Medicare spending and costs to taxpayers and the Medicare program.
New and stronger supplier service and compliance obligations will raise operational costs and may push some suppliers to exit or consolidate, reducing local availability and access—especially in rural or low-volume areas.
Higher mandated payments and expanded covered services (plus likely greater utilization) could increase beneficiary out-of-pocket costs for some patients where cost-sharing applies.
Based on analysis of 8 sections of legislative text.
Removes oxygen DME from competitive bidding, moves payments to the DME fee schedule, creates a respiratory‑therapist add‑on, requires electronic orders/notices, and establishes patient rights beginning Jan 1, 2026.
Removes supplemental oxygen and related equipment, supplies, and services from Medicare’s Competitive Acquisition Program and moves their payment to the durable medical equipment fee-schedule rules for items furnished on or after January 1, 2026. Creates a new monthly non‑budget‑neutral add‑on payment for respiratory therapist services, requires an electronic ordering template and electronic claim adjudication, strengthens beneficiary notices about the 36‑month rental cap, and establishes patient rights and supplier obligations for oxygen services under Medicare Part B. Implements detailed payment formulas (including geographic/blended rules for rural/non‑contiguous areas), requires HHS rulemaking and stakeholder consultation, restores pre‑2009 clinical inference in audits, and directs new supplier and beneficiary notice and grievance procedures to protect patient access and transparency beginning in 2026.