CQRC leads way on oxygen reform

WASHINGTON – The fact that the HME industry, physician groups and patient groups are all in alignment on what needs to be done to fix the Medicare oxygen benefit should help to propel a new bill forward, says Dan Starck, interim chair of the Council for Quality Respiratory Care. 

The Supplemental Oxygen Access Reform (SOAR) Act, introduced in late February in the Senate and in late March in the House of Representatives, has support from heavy hitters like the American Lung Association, the COPD Foundation and the American College of Chest Physicians, in addition to industry groups like AAHomecare and the VGM Group.  

“It’s the first time, at least in my history in the industry, that (we’ve) all been on the same page asking for the same thing,” said Starck. “It’s really played out positively, especially when you understand and know who are the lead sponsors. For us to have all those folks, it’s really impressive.” 

The bill was introduced in the Senate by Sens. Bill Cassidy, MD., R-La., Mark Warner, D-Va., and Amy Klobuchar, D-Minn., and in the House by Reps. David Valadao, R-Calif.; Julia Brownley, D-Calif.; Larry Bucshon, R-Ind., and Adrian Smith, R-Neb. 

The SOAR Act would remove supplemental oxygen from competitive bidding, permanently extend Medicare’s blended reimbursement rates, reimburse for respiratory therapy services and establish a separate payment system for liquid oxygen. 

“The economics made no sense for anyone to provide liquid oxygen at a large scale,” said Starck. “When you get into high flow patients, there isn’t a good solution for them, so the decline in the availability has led to a real access issue.” 

The bill would also mandate the use of a template for documentation, something the industry has been pushing for, says Starck. 

“(With a template), we can move away from a subjective review of physician chart notes to an objective view with test results and necessary data so that everyone understands the ground rules around what qualifications and what test results are required,” he said. 

The CQRC is taking the lead role in building support for the bill and believes, with the backing of such a broad coalition of groups, there’s a strong argument for moving it forward. 

“With the SOAR Act introduced in the U.S. House and Senate, CQRC is working with the patient, physician, therapist, supplier and manufacturer communities to expand congressional support for this comprehensive oxygen reform package,” Starck said. “Our hope is that Congress will move SOAR through the relevant committees and fold our reform provisions into any must-pass legislative packages before the end of the year.” 

While it supports the SOAR Act, AAHomecare’s top priority continues to be new opportunities to pass H.R. 5555 and S. 1295, bills that that would extend the 75/25 Medicare blended reimbursement rate in non-bid areas through 2024 – not only for oxygen but all HME. 

“Supplemental oxygen is critically important to millions of Americans and their caregivers, and Medicare policy needs to better reflect that urgency,” said Tom Ryan, president & CEO of AAHomecare. “We certainly support the SOAR Act and its aim to strengthen access to oxygen by bolstering reimbursements and streamlining documentation requirements. However, our focus remains on bolstering rates across the full spectrum of products and extending the 75/25 relief in the near term.”