Medicare removes oxygen from cost-cutting bidding, raises supplier pay
S. 1406 — SOAR Act of 2025 · Filed by Bill Cassidy (R-LA) · 8 cosponsors · Introduced Apr 10, 2025 · Referred to committee
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What it does
The SOAR Act removes supplemental oxygen from Medicare's competitive bidding program and establishes new payment rates tied to 2025 fee schedules (with annual CPI adjustments). It requires suppliers to provide comprehensive services (24-hour coverage, portable equipment, patient education, monitoring), adds payment for respiratory therapist services, mandates electronic templates for medical necessity documentation, and establishes detailed beneficiary rights including supplier choice, grievance protections, and monthly notices of cost-sharing obligations. The bill aims to improve patient access to oxygen therapy by stabilizing supplier payments and strengthening service quality standards.
Why we flagged it
The bill's core mechanism is a structural shift in how Medicare pays for oxygen therapy—removing competitive bidding and establishing new fee-schedule-based rates—coupled with expanded beneficiary protections and supplier service obligations. This is fundamentally a reimbursement and service-quality reform, not a commemorative, appropriations, or deregulatory measure.
What the text implies
- Removal from competitive bidding may increase Medicare program costs significantly, as fee-schedule rates are typically higher than competitive-bid rates; no budget offset is specified.
- Respiratory therapist services are newly covered under Medicare, expanding the scope of reimbursable oxygen-related care and potentially increasing total program expenditure.
- The 'non-budget neutral' language in Sections 201(b) and 301 explicitly signals that these add-ons are not offset by reductions elsewhere, indicating intentional program cost increases.
- Beneficiary grievance protections include explicit anti-retaliation language, which may increase supplier compliance costs and litigation exposure for suppliers who violate these provisions.
- The 36-month rental cap for oxygen equipment (referenced in Section 302) remains in place; beneficiaries do not own equipment after 36 months, limiting long-term cost savings despite higher supplier payments.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Beneficiaries gain enforceable rights to supplier choice, grievance protections without retaliation, 24-hour coverage, portable equipment, and monthly cost-sharing notices. Suppliers' higher, stable payments enable them to provide these enhanced services. The bill prioritizes patient access and safety over cost containment, with no apparent restrictions on beneficiary remedies or protections.
Who stands to gain
- oxygen suppliers and DME providers
- oxygen equipment manufacturers
- respiratory therapists and respiratory therapy services
- liquid oxygen suppliers (subject to 200% of 2015 fee-schedule floor)
Named in the bill
Medicare (Title XVIII, Social Security Act), Secretary of Health and Human Services, Medicare Administrative Contractors, oxygen suppliers and DME providers, respiratory therapists, oxygen equipment manufacturers, beneficiaries (Medicare enrollees), prescribing practitioners/physicians
Where it stands
8 cosponsors: 6 Republicans, 2 Democrats.
- Apr 10, 2025 — Introduced · Congress.gov: “Introduced in Senate”
- Apr 10, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
11 lobbying clients named this bill on 17 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $2,840,000 in lobbying spend. A filing names 6 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 92% of bills with at least one filing.
Bill Cassidy, the sponsor, reported $1,329,254 in PAC receipts in the 2026 cycle.
- American Association for Homecare — $800,000 on 2 filings
- Accendra Health Inc. — $740,000 on 3 filings
- Medline — $400,000 on 1 filing
- Cystic Fibrosis Foundation — $270,000 on 1 filing
- American Lung Association — $190,000 on 2 filings
Lobbying Disclosure Act filings through Jul 22, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (22,833 characters) on Aug 13, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 22, 2026 · page rendered 2026-10-20.
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