Restoring access to supplemental oxygen in Medicare

By Tom Ryan

This is a lightly edited excerpt of testimony recently provided to the U.S. House’s Energy and Commerce Health Subcommittee hearing titled, “Legislative Proposals to Support Patient Access to Medicare Services.”

On April 10, 2025, Representatives David Valadao, Julia Brownley, Adrian Smith and Gabe Evans introduced the Supplemental Oxygen Access Reform Act of 2025 (H.R. 2902) to address the well-documented patient access barriers to accessing supplemental oxygen, particularly liquid oxygen. The legislation would lock in the substantial savings Medicare has already obtained during previous rounds of competitive bidding and create a new payment methodology for liquid oxygen. Moreover, it would address the ongoing concerns about fraud and abuse by leveraging technology-based solutions — a national standardized electronic template completed by the prescriber and shared electronically with both the provider and CMS. This policy will greatly reduce fraud and abuse along with the cost burden of audits for both CMS and providers. Moreover, the legislation would establish patient protections as well. It would also recognize the importance of patient access to respiratory therapists' services, which are often necessary — especially when they are given a new oxygen prescription — to support individuals' care, by reimbursing for these services.

Since 2011, supplemental oxygen has been part of Medicare’s DMEPOS Competitive Bidding Program, resulting in significant decreases in payments for oxygen equipment and supplies. While we appreciate that payment reductions have produced Medicare savings, they have also led to serious barriers to patients accessing medically necessary oxygen equipment, supplies, and services. The rates for liquid oxygen are far below the cost suppliers incur to fill physician prescriptions. Under the current reimbursement methodology, many individuals who require supplemental oxygen do not receive the types of oxygen systems that are needed. As a result, these individuals are at high risk for worsening health, avoidable emergency room visits, and hospitalizations.

It is critically important to stabilize the Medicare supplemental oxygen benefit to provide beneficiary access to the equipment that best addresses their medical needs. Individuals with the most significant oxygen needs cannot use small, portable oxygen concentrators (known as POCs) because they do not provide high flow rates. Instead, these people are currently dependent on large tanks of compressed, gaseous oxygen. These large tanks of oxygen are heavy, bulky and may provide only a couple of hours of oxygen at a time. People who have any sort of mobility issues struggle to get around with even one of these large tanks.  Consequently, those individuals who need high flow rates often end up effectively housebound.  

The SOAR Act would bring significant health and well-being benefits to the 1.5 million individuals living with COPD, heart disease, pulmonary hypertension, pulmonary fibrosis, people awaiting lung transplants and other advanced respiratory diseases who rely on supplemental oxygen. Oxygen therapy can decrease mortality, reduce shortness of breath, and increase exercise capacity.  

Read the summary of the full testimony here.

Tom Ryan is the president and CEO of AAHomecare.

_{*The opinions expressed in this column are those of the author and do not necessarily reflect the views of HealthPlatform.News.}