More than 30 healthcare and advocacy organizations have sent a letter to Congressional leaders to ask them to include the Supplemental Oxygen Access Reform (SOAR) Act in end-of-year healthcare legislative packages that might be under consideration.
The Nov. 10 letter was sent to Senate Majority Leader John Thune (R-S.D.), Senate Minority Leader Chuck Schumer (D-N.Y.), Speaker of the House Mike Johnson (R-La.), and House Minority Leader Hakeem Jeffries (D-N.Y.).
The bipartisan SOAR Act is H.R. 2902 in the U.S. House of Representatives and S. 1406 in the U.S. Senate.
“Sponsored by Reps. David Valadao (R-Calif.), Gabe Evans (R-Colo.), Adrian Smith (R-Neb.) and Julia Brownley (D-Calif.) in the House and by Sens. Bill Cassidy (R-La.), Mark Warner (D-Va.) and Amy Klobuchar (D-Minn.) in the Senate, this legislation would ensure that Medicare beneficiaries who require supplemental oxygen have appropriate access to this essential treatment,” the letter said. “It would lock in the savings obtained through the competitive bidding program (CBP), which reduced the cost of supplemental oxygen more than 75 percent, and nearly (if not entirely) eliminate fraud due to insufficient documentation of medical necessity.”
The letter added that the SOAR Act impacts more than 1.5 million Americans who depend on supplemental oxygen. “Yet far too many are facing serious health risks and reduced quality of life because they do not currently have access to the appropriate supplemental oxygen equipment and services, especially those who require high-flow, liquid oxygen,” the letter said. “Further delay will result in more patients losing access to medically necessary oxygen and related services. Patients have already experienced a lack of innovative treatment options, difficulty obtaining repairs because of a shortage of parts, and challenges obtaining new devices as manufacturers stop building new devices.”
The organizations who signed the letter said SOAR legislation would create a new reimbursement system “with a new capitated payment for liquid oxygen. It would also lock in the savings for the majority of other oxygen modalities by removing them from CBP, which will help keep beneficiary copayments for these modalities low and affordable.”
Oxygen was not among the competitive bidding categories listed for Round 2028, but in an Oct. 27 HME Business webinar, panelist Cara C. Bachenheimer, general counsel for the American Association for Homecare and a shareholder with Brown & Fortunato, said suppliers should anticipate that additional product categories could be included in future competitive bidding rounds.
“A lot of folks in let’s say the traditional areas such as respiratory may not be impacted by this,” Bachenheimer said. “But if you remember back when people were impacted originally by the competitive bidding program in the metropolitan areas, others said, ‘Oh, I’m not involved. I’m in a rural area.’ Well, it came around that it impacts everybody because the [reimbursement] rates fell.
“And this program, if it moves forward in the same way, will be rolled out to additional product categories that have previously been bid. These are just the new rules of the road.”
Protection against fraud and abuse
The letter added that the SOAR Act would protect the Medicare trust fund from fraud and abuse “by mandating standardized documentation requirements that rely on an electronic ‘template,’ rather than faxes of prescriber medical records, and establishing specific obligations for suppliers to maintain quality oxygen service to beneficiaries. It would recognize the critical medical need for respiratory therapy services
by establishing an adjustment when these services are provided to ensure that individuals who use supplemental oxygen have the necessary training on using their oxygen.
“Finally, it would establish protections for Medicare beneficiaries, including their right to receive clear
communication and information from suppliers.”
Among the organizations signing the letter were the American Association for Homecare (AAHomecare), the American Association for Respiratory Care, the American College of Chest Physicians, the American Physical Therapy Association, the COPD Foundation, the Council for Quality Respiratory Care, and the VGM Group.
