The push to overhaul oxygen access is breathing new life in Congress, but advocates warn the federal shutdown may suffocate momentum for the Supplemental Oxygen Access Reform (SOAR) Act in 2025.
First introduced to Congress in 2024, the SOAR Act was reintroduced to the House of Representatives in February 2025 with bipartisan support and the endorsement of more than 30 patient, health care professional, and industry organizations, including CHEST, the American Lung Association, and the American Thoracic Society. Yet, despite broad backing, the bill’s future remains uncertain.
If enacted, the SOAR Act—sponsored by Senator Bill Cassidy (R-LA) and Representative David Valadao (R-CA) and cosponsored by 32 members of Congress—would remove all oxygen and oxygen equipment from Medicare competitive bidding, establish a separate payment rate for liquid oxygen, and create a new add-on to the supplemental oxygen rate to reimburse respiratory therapist services to Medicare beneficiaries. It would also establish protections for Medicare beneficiaries who use supplemental oxygen and ensure program integrity by strengthening fraud and abuse protections.
“In my opinion, the most impactful change the SOAR Act could bring about would be for those patients who require very high oxygen levels to support their activities of daily living,” said CHEST Past President John E. Studdard, MD, Master FCCP, a retired pulmonologist from Jackson, Mississippi. “The decreased reimbursement has particularly impacted those patients who previously depended on liquid oxygen. Liquid delivery offered patients portability and high oxygen levels without which a patient’s activities are frequently limited to being homebound or bound to a hospital or long-term care facility.”
A key provision of the SOAR Act is the creation of an electronic template to document medical necessity, streamline documentation by reducing reliance on full medical record reviews, and enhance protections against fraud and abuse. Created with the guidance of CHEST experts, the eClinical oxygen template includes standardized clinical data elements that would clearly indicate the information prescribers need to provide when ordering supplemental oxygen for their patients to avoid denials.
“A template could be a very valuable mechanism to reduce fraud and to decrease incorrect oxygen prescriptions being delivered to the wrong patients,” said Dr. Studdard, who estimates that around 1.5 million patients in the United States require home oxygen—at least 100,000 of whom require higher oxygen concentrations. “It would be valuable to suppliers, providers, and patients.”
In his view, the biggest impact of competitive bidding has been reduced reimbursement, which has slowed innovation in oxygen delivery.
“Industry—given the poor reimbursement in oxygen, and in particular liquid oxygen—has been very slow to invest in innovation in oxygen delivery,” Dr. Studdard said. “There has been little advancement in technology. Also, patients and providers have been limited by the lack of choice of suppliers to use. This can be problematic when a patient relocates.”
In addition, decreased reimbursement under competitive bidding has led to a reduction in services offered to patients, including respiratory therapy and other forms of patient support from suppliers.
“When support services are cut, there is a potential increase in patient visits to emergency departments and hospitalizations, as well as office visits,” he said.
Dr. Studdard characterized the SOAR Act as “a great example of manufacturers, providers, suppliers, and patient groups all working together, building alignment, and speaking with one voice.”
CHEST will continue to provide expertise that supports and advocates for passing this bill.
