119-s1406

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1406 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 1406

To amend title XVIII of the Social Security Act to improve the payment 
method for oxygen and oxygen related equipment, supplies, and services, 
to increase beneficiary access to oxygen and oxygen related equipment, 
 supplies, and services, and for other purposes.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 April 10, 2025

Mr. Cassidy (for himself, Ms. Klobuchar, and Mr. Warner) introduced the 
 following bill; which was read twice and referred to the Committee on 
 Finance

_______________________________________________________________________

 A BILL

To amend title XVIII of the Social Security Act to improve the payment 
method for oxygen and oxygen related equipment, supplies, and services, 
to increase beneficiary access to oxygen and oxygen related equipment, 
 supplies, and services, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Supplemental 
Oxygen Access Reform Act of 2025'' or the ``SOAR Act of 2025''.

    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--PROTECT BENEFICIARY ACCESS TO SUPPLEMENTAL OXYGEN THERAPY IN 
 THE HOME AND COMMUNITY

Sec. 101. Reform of the medicare supplemental oxygen benefit.

Sec. 102. Establishment of supplemental oxygen responsibilities 
 criteria.

Sec. 103. Technical corrections.
 TITLE II--PROTECTING BENEFICIARY ACCESS TO RESPIRATORY THERAPISTS

Sec. 201. Reimbursement for respiratory therapists.
 TITLE III--ADOPTION OF ELECTRONIC TEMPLATES TO STRENGTHEN FRAUD AND 
 ABUSE PROTECTIONS AND ENSURE PROGRAM INTEGRITY

Sec. 301. Strengthening program integrity through the use of electronic 
 templates to document medical necessity, 
 and restoring clinical inference for oxygen 
 and oxygen related equipment, supplies, and 
 services.

Sec. 302. Establishing notice requirements for individuals receiving 
 oxygen or oxygen related equipment, 
 supplies, or services.
 TITLE IV--ESTABLISHMENT OF BENEFICIARY RIGHTS

Sec. 401. Establishing protections for individuals receiving oxygen or 
 oxygen related equipment, supplies, or 
 services.

 TITLE I--PROTECT BENEFICIARY ACCESS TO SUPPLEMENTAL OXYGEN THERAPY IN 
 THE HOME AND COMMUNITY

SEC. 101. REFORM OF THE MEDICARE SUPPLEMENTAL OXYGEN BENEFIT.

    (a) Removing Oxygen and Oxygen Related Equipment, Supplies, and 
Services From Competitive Acquisition Program To Improve Patient Access 
to Supplemental Oxygen Therapy.--

Section 1847

    (a)

    (3) of the Social 
Security Act (42 U.S.C. 1395w-3

    (a)

    (3) ) is amended by--

    (1) inserting ``and exclusion'' after ``exception 
 authority'';

    (2) by redesignating subparagraphs
        (A) and
        (B) as clauses
            (i) and
            (ii) , respectively, and moving such clauses as so 
 redesignated 2 ems to the right;

    (3) by striking ``In carrying out'' and inserting the 
 following:
 ``
        (A) In general.--In carrying out''; and

    (4) by adding at the end the following new subparagraph:
 ``
        (B) Exclusion of oxygen, and oxygen related 
 equipment, supplies, and services.--Beginning on or 
 after January 1, 2026, the Secretary shall exclude 
 oxygen and oxygen related equipment, supplies, and 
 services from the competitive acquisition program under 
 this section and payment for oxygen and oxygen related 
 equipment, supplies, and services shall be made as 
 prescribed under subparagraphs
        (E) ,
        (F) , and
        (H) of 
 

section 1834

    (a)

    (9) .''.

    (b) Establishing Adequate Payment for Oxygen and Oxygen Related 
Equipment, Supplies, and Services.--

Section 1834

    (a)

    (9) of the Social 
Security Act (42 U.S.C. 1395m

    (a)

    (9) ) is amended--

    (1) in the first sentence of the matter preceding 
 subparagraph
        (A) , by inserting the following before the period: 
 ``(for oxygen and oxygen equipment furnished before January 1, 
 2026) or the amount determined under subparagraph
        (E) , subject 
 to subparagraphs
        (F) ,
        (G) , and
        (H) (for oxygen and oxygen 
 related equipment, supplies, and services furnished on or after 
 January 1, 2026);''; and

    (2) by adding at the end the following:
 ``
        (E) Payment for oxygen and oxygen related 
 equipment, supplies, and services excluded from 
 competitive acquisition program.--Subject to 
 subparagraphs
        (F) ,
        (G) , and
        (H) in the case of oxygen 
 and oxygen related equipment, supplies, and services 
 furnished on or after January 1, 2026--
 ``
            (i) in areas that are competitive bidding 
 areas in which a competitive bidding program is 
 implemented for other covered items, the 
 payment amount is equal to--
 ``
            (I) for 2026, the fee schedule 
 amounts for the area for items and 
 services in effect on December 31, 
 2025; and
 ``
            (II) for each subsequent year, 
 the amount determined under this clause 
 for the preceding year, increased by 
 the percentage increase in the consumer 
 price index for all urban consumers 
 (United States city average) for the 
 12-month period ending on December 31 
 of the previous year;
 ``
            (ii) in rural areas and non-contiguous 
 areas (Alaska, Hawaii, and United States 
 territories), the payment amount is equal to--
 ``
            (I) 50 percent of 110 percent of 
 the national average price for the item 
 or service determined under 

section 414.210

    (g)

    (1)
            (ii) of title 42, Code of 
 Federal Regulations; and
 ``
            (II) 50 percent of--
 ``

    (aa) for 2026, the fee 
 schedule amount for the area in 
 effect on December 31, 2025; 
 and
 ``

    (bb) for each subsequent 
 year, the amount determined 
 under this subclause for the 
 preceding year, increased by 
 the percentage increase in the 
 consumer price index for all 
 urban consumers (United States 
 city average) for the 12-month 
 period ending on December 31 of 
 the previous year; and
 ``
            (iii) in areas other than those described 
 in clauses
            (i) and
            (ii) , the payment amount is 
 equal to the sum of 75 percent of the adjusted 
 payment amount established under clause
            (i) and 
 25 percent of the unadjusted fee schedule 
 amount otherwise determined without taking into 
 account this subparagraph.
 ``
        (F) Special rule for liquid oxygen.--
 ``
            (i) Payment.--
 ``
            (I) In general.--In lieu of the 
 volume adjustment established under 
 paragraph

    (5)
            (C) , not later than 
 January 1, 2026, the Secretary in 
 consultation with suppliers, 
 manufacturers, patients and patient 
 advocates, and physicians, and through 
 notice-and-comment rulemaking, shall 
 establish a separate payment amount 
 that meets the requirements of this 
 subparagraph made to a supplier for the 
 provision of liquid oxygen and liquid 
 oxygen related equipment, supplies, and 
 services that meets the requirements 
 described in subparagraph
        (G) .
 ``
            (II) Payment floor.--The payment 
 amount established under subclause
            (I) may not be less than an amount equal to 
 200 percent of the 2015 Durable Medical 
 Equipment, Prosthetics/Orthotics & 
 Supplies Fee Schedule updated by the 
 consumer price index for all urban 
 consumers (United States city average) 
 for years 2016 through 2025.
 ``
            (III) Update mechanism.--
 Beginning on January 1, 2027, the 
 payment amount described in subclause
            (I) shall be increased annually by the 
 projected percentage increase in the 
 consumer price index for all urban 
 consumers (United States city average) 
 for the 12-month period ending December 
 31 of the previous year.
 ``
            (ii) Considerations.--In implementing the 
 payment amount under this subparagraph, the 
 Secretary shall take into account the cost of 
 liquid oxygen on a per pound basis, the cost of 
 liquid oxygen equipment, the infrastructure 
 costs associated with providing liquid oxygen 
 equipment and supplies (including labor, 
 storage, transportation, maintenance, and 
 similar costs), the cost of complying with 
 Federal and State regulations specific to the 
 delivery and transportation of liquid oxygen, 
 and any other cost factors the Secretary deems 
 appropriate after consulting with stakeholders 
 such as suppliers, providers, patients and 
 patient advocates, and manufacturers.
 ``
            (iii) Monthly add-on for high-flow 
 patients.--
 ``
            (I) In general.--Subject to 
 subclause
            (II) , the Secretary shall 
 establish a non-budget neutral add-on 
 to the payment amount under clause
            (i) when the prescribing practitioner 
 orders an oxygen flow rate equal to or 
 greater than 6 liters per minute.
 ``
            (II) Add-on amount.--The add-on 
 amount shall equal the per pound cost 
 of the oxygen exceeding the amount 
 required to provide a liter flow that 
 is equal to or greater than 6 liters 
 per minute.
 ``
            (iv) Periodic assessment of the base 
 rate.--The Secretary shall assess at least once 
 every 3 years the adequacy of the payment 
 amounts under this subparagraph on a cost-
 related basis or other economical and equitable 
 basis.
 ``
            (v) Transitional interim payment.--
 ``
            (I) In general.--For items and 
 services furnished on or after the date 
 of the enactment of the SOAR Act of 
 2025 and prior to the implementation of 
 the payment amount established under 
 this subparagraph, the Secretary shall 
 adopt a transitional interim payment 
 amount for liquid oxygen, and liquid 
 oxygen equipment, supplies, and 
 services in an amount equal to 200 
 percent of the 2015 Durable Medical 
 Equipment, Prosthetics/Orthotics & 
 Supplies Fee Schedule updated by the 
 consumer price index for all urban 
 consumers (United States city average) 
 for years 2016 through 2025.
 ``
            (II) Update.--This amount shall 
 be updated annually by the projected 
 percentage change in the consumer price 
 index for all urban consumers (United 
 States city average) for the 12-month 
 period ending on December 31 of the 
 previous year, until the Secretary 
 implements the payment amount under 
 this subparagraph.
 ``
            (vi) Coverage criteria.--
 ``
            (I) In general.--Not later than 
 January 1, 2026, the Secretary, in 
 consultation with stakeholders, shall 
 establish objective clinical criteria 
 for the coverage of liquid oxygen, and 
 liquid oxygen equipment, supplies, and 
 services under this title.
 ``
            (II) Update of criteria.--The 
 Secretary shall review and update the 
 coverage standards under this clause 
 every 5 years to ensure the standards 
 take into consideration current medical 
 and clinical guidelines and take into 
 effect modality in order to maximize 
 beneficiary independence.''.

SEC. 102. ESTABLISHMENT OF SUPPLEMENTAL OXYGEN RESPONSIBILITIES 
 CRITERIA.

    (a) In General.--

Section 1834

    (a)

    (9) of the Social Security Act (42 
U.S.C. 1395m

    (a)

    (9) ), as amended by 

section 101

    (b) , is further amended 
by inserting the following new subparagraph:
 ``
        (G) Oxygen and oxygen related equipment, 
 supplies, and services.--In consultation with 
 stakeholders, the Secretary shall define the scope of 
 services a supplier of oxygen and oxygen related 
 equipment, supplies, and services must provide to 
 receive payment under this part, to include--
 ``
            (i) conducting an initial evaluation of 
 the beneficiary using the uniform oxygen 
 patient evaluation form described in paragraph

    (5)
        (G) to determine the appropriate use of 
 oxygen and oxygen related equipment, supplies, 
 and services by the beneficiary, including the 
 use of portable equipment;
 ``
            (ii) ensuring the beneficiary has 
 appropriate access to portable oxygen, and 
 portable oxygen equipment, supplies, and 
 services based on the mobility needs of the 
 beneficiary, including the needs of the 
 beneficiary outside the home of the 
 beneficiary;
 ``
            (iii) providing written and verbal 
 beneficiary and caregiver education regarding 
 oxygen and oxygen related equipment, supplies, 
 and services, stationary and portable options, 
 and oxygen safety, which includes evaluating 
 the environment of the beneficiary for safety 
 risks or hazards, such as fire and fall 
 hazards;
 ``
            (iv) providing appropriate delivery, set-
 up, and coordination of oxygen services 
 (including the delivery of any oxygen equipment 
 or supplies to a beneficiary prior to such 
 beneficiary being discharged, delivering such 
 equipment, and setting up the equipment), as 
 needed, in a timely manner as agreed upon by 
 the beneficiary or caregiver, supplier, and 
 prescribing practitioner;
 ``
            (v) evaluating the ability of the 
 beneficiary to operate the equipment safely and 
 effectively;
 ``
            (vi) providing infection control 
 information and instructions about all 
 equipment and supplies;
 ``
            (vii) providing equipment-related 
 services, including checking oxygen system 
 purity levels and flow rates, changing and 
 cleaning filters, and assuring the integrity of 
 alarms and back-up systems, consistent with the 
 manufacturer specifications and in accordance 
 with all Federal, State, and local laws and 
 regulations;
 ``
            (viii) monitoring visits when necessary 
 by appropriate personnel, including a 
 respiratory therapist to evaluate all aspects 
 of the services being provided to the 
 beneficiary by the provider;
 ``
            (ix) documenting exception reporting by 
 the supplier to the prescribing physician when 
 changes occur in the compliance of the 
 beneficiary with the beneficiary's plan of 
 care;
 ``
            (x) providing, as needed, continued 
 education to the beneficiary or caregiver 
 regarding appropriate oxygen equipment 
 maintenance practices and performance;
 ``
            (xi) providing, as prescribed by the plan 
 of care of the prescribing practitioner, 
 appropriate oxygen and oxygen related 
 equipment, supplies, and services (including 
 supplemental supplies and emergency oxygen 
 back-ups as appropriate);
 ``
            (xii) ensuring oxygen and oxygen 
 equipment can be used appropriately outside the 
 home of a beneficiary based on necessity;
 ``
            (xiii) providing 24-hour on-call coverage 
 to respond to beneficiary needs relating to 
 oxygen and oxygen related equipment, supplies, 
 and services; and
 ``
            (xiv) assisting the beneficiary with the 
 coordination of oxygen and oxygen related 
 equipment, supplies, and services, including by 
 assisting the beneficiary to find a different 
 supplier if the beneficiary temporarily travels 
 outside of the service area of the supplier. If 
 the beneficiary relocates permanently, the new 
 supplier caring for the beneficiary will assume 
 responsibility for billing the Medicare program 
 directly.''.

    (b) Effective Date.--The amendment made by this section shall take 
effect on the date that is 1 year after the date of enactment of this 
Act.

SEC. 103. TECHNICAL CORRECTIONS.

 

Section 1861

    (n) is amended by striking ``iron lungs, oxygen tents'' 
and inserting ``oxygen and oxygen related equipment, supplies, and 
services''.

 TITLE II--PROTECTING BENEFICIARY ACCESS TO RESPIRATORY THERAPISTS

SEC. 201. REIMBURSEMENT FOR RESPIRATORY THERAPISTS.

    (a) Protecting Access to Respiratory Therapist Services.--

    (1) Adding respiratory therapist services to the definition 
 of medical and other health services.--

Section 1861

    (s)

    (2) of 
 the Social Security Act (42 U.S.C. 1395x

    (s)

    (2) ) is amended--
        (A) in subparagraph

    (JJ) , by inserting ``and'' 
 after the semicolon; and
        (B) by adding at the end the following new 
 subparagraph:
 ``

    (KK) respiratory therapist services (as defined 
 in subsection

    (nnn) ) furnished on or after January 1, 
 2026.''.

    (2) Definition of respiratory therapist services.--

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by 
 adding at the end the following new subsection:
 ``

    (nnn) Respiratory Therapist Services.--The term `respiratory 
therapist services' means services performed by a respiratory therapist 
within the scope of practice of a respiratory therapist as defined by 
State law, regulations, and applicable accreditation standards for the 
assessment, treatment, and monitoring of patients requiring oxygen and 
oxygen related equipment, supplies, or services.''.

    (b) Add-On Payment Adjustment.--

Section 1834

    (a)

    (9) of the Social 
Security Act (42 U.S.C. 1395m

    (a)

    (9) ), as amended by sections 101

    (b) and 
102

    (a) , is further amended by adding at the end the following new 
subparagraph:
 ``
        (H) Monthly payment add-on adjustment for 
 respiratory therapist services.--For respiratory 
 therapist services furnished on or after January 1, 
 2026, the Secretary shall implement through notice and 
 comment rulemaking and in consultation with 
 stakeholders a non-budget neutral add-on payment 
 adjustment to the payment amount established under this 
 paragraph that reflects the cost of providing 
 respiratory therapist services as clinically 
 appropriate under State law.''.

 TITLE III--ADOPTION OF ELECTRONIC TEMPLATES TO STRENGTHEN FRAUD AND 
 ABUSE PROTECTIONS AND ENSURE PROGRAM INTEGRITY

SEC. 301. STRENGTHENING PROGRAM INTEGRITY THROUGH THE USE OF ELECTRONIC 
 TEMPLATES TO DOCUMENT MEDICAL NECESSITY, AND RESTORING 
 CLINICAL INFERENCE FOR OXYGEN AND OXYGEN RELATED 
 EQUIPMENT, SUPPLIES, AND SERVICES.

    (a) Adopting Electronic Templates for Determining Medical 
Necessity.--

Section 1834

    (a)

    (5) of the Social Security Act (42 U.S.C. 
1395m

    (a)

    (5) ) is amended by adding at the end the following:
 ``
        (G) Adoption of electronic templates to document 
 medical necessity and strengthen program integrity.--
 ``
            (i) In general.--For any oxygen and 
 oxygen related equipment, supplies, or service, 
 including liquid oxygen, furnished on or after 
 January 1, 2026, the Secretary shall adopt a 
 template in an electronic format that meets the 
 requirements of clause
            (ii) to be completed by 
 the prescribing practitioner (as defined by the 
 Secretary) that shall constitute the complete 
 request for information to determine whether 
 payment for such service, equipment, or 
 supplies is covered by this title and is 
 reasonable and necessary for the diagnosis or 
 treatment of illness or injury (under 

section 1862

    (a)

    (1)
        (A) ).
 ``
            (ii) Template requirements.--The template 
 shall require the prescribing practitioner to 
 provide each of the following:
 ``
            (I) Documentation that the 
 beneficiary was seen by a prescribing 
 practitioner within the appropriate 
 timeframes for certification of the 
 need for the services, equipment, or 
 supplies.
 ``
            (II) Documentation of the 
 qualifying blood gas or saturation test 
 results.
 ``
            (III) Documentation indicating 
 that the beneficiary needs or is using 
 the appropriate equipment, supplies, 
 and services.
 ``
            (IV) Any other documentation 
 determined appropriate by the 
 Secretary, except the Secretary shall 
 not require the prescribing 
 practitioner to provide medical record 
 notes regarding the beneficiary.
 ``
            (iii) Contractor adjudication.--The 
 Secretary shall require Medicare administrative 
 contractors to adjudicate claims for payment 
 for oxygen and oxygen related equipment, 
 supplies, and services using electronic 
 transactions.
 ``
        (H) Restoration of clinical inference and 
 judgment.--For claims submitted on or after the date of 
 enactment of this subparagraph with respect to the 
 conduct of payment audits of suppliers of oxygen and 
 oxygen related equipment, supplies, and services under 
 this part the Secretary shall use clinical inference 
 and clinical judgment in the evaluation of templates, 
 medical records, and orders when conducting such audits 
 in the same manner as the Secretary interpreted and 
 applied such clinical judgment to claim reviews before 
 2009 pursuant to the Secretary's instruction to 
 contractors.''.

SEC. 302. ESTABLISHING NOTICE REQUIREMENTS FOR INDIVIDUALS RECEIVING 
 OXYGEN OR OXYGEN RELATED EQUIPMENT, SUPPLIES, OR 
 SERVICES.

    (a) Annual Notice of Cost-Sharing Obligations for Supplemental 
Oxygen.--

Section 1804 of the Social Security Act (42 U.S.C. 1395b-2) is 
amended by adding at the end the following new subsection:
 ``

    (e) The notice provided under subsection

    (a) shall include--
 ``

    (1) a description of--
 ``
        (A) the 36-month rental period for supplemental 
 oxygen equipment under 

section 1834

    (a)

    (5)
        (F) ;
 ``
        (B) the right of a beneficiary to discuss their 
 prescription for supplemental oxygen equipment with 
 their prescribing physician or practitioner; and
 ``
            (C) any cost sharing requirements for 
 supplemental oxygen equipment, supplies, and services 
 under this title and the termination of such 
 requirements when a beneficiary refuses or discontinues 
 supplemental oxygen therapy; and
 ``

    (2) information on the internal and external grievance 
 processes of suppliers of oxygen and oxygen related equipment, 
 supplies, and services under this title (as well as how to 
 contact Medicare through a hotline or beneficiary ombudsman), 
 including the right of a beneficiary to file, personally or 
 through a representative of the beneficiary's choosing, an 
 internal or external grievance without retaliation or denial of 
 services from a supplier.''.

    (b) Timely Notice of End of Cost-Sharing Obligations for 
Supplemental Oxygen.--

Section 1834

    (a)

    (5)
        (F) of the Social Security Act 
(42 U.S.C. 1395m

    (a)

    (5)
        (F) ), is amended by adding at the end the 
following new clause:
 ``
            (iii) Timely notice of end of cost-
 sharing obligations for supplemental oxygen.--
 The Secretary, in consultation with patient 
 advocates, physicians, supplemental oxygen 
 suppliers, respiratory therapists, and other 
 stakeholders, shall distribute a monthly notice 
 to each individual receiving supplemental 
 oxygen equipment, supplies, and services 
 stating the number of months remaining within 
 the rental cap period under this subparagraph 
 during which the beneficiary is responsible for 
 the copayment amount for such equipment.''.

 TITLE IV--ESTABLISHMENT OF BENEFICIARY RIGHTS

SEC. 401. ESTABLISHING PROTECTIONS FOR INDIVIDUALS RECEIVING OXYGEN OR 
 OXYGEN RELATED EQUIPMENT, SUPPLIES, OR SERVICES.

 

Section 1834

    (a)

    (5) of the Social Security Act (42 U.S.C. 
1395m

    (a)

    (5) ), as amended by 

section 301, is further amended by adding 
at the end the following new subparagraph:
 ``
        (H) Establishing protections for individuals 
 receiving oxygen or oxygen related equipment, supplies, 
 or services.--The Secretary shall establish through 
 regulation protections for any individual receiving 
 oxygen or oxygen related equipment, supplies, or 
 services under this part where such individual shall 
 have the right to--
 ``
            (i) choose the local supplier of such 
 services from among qualified suppliers and to 
 change such supplier;
 ``
            (ii) receive communications from the 
 supplier in a clear and understandable manner;
 ``
            (iii) ensure privacy and confidentiality 
 in all aspects of treatment and the personal 
 health information of such individual 
 consistent with Federal and State laws;
 ``
            (iv) be informed by the supplier of such 
 services regarding--
 ``
            (I) all aspects of the services 
 being furnished by such supplier;
 ``
            (II) the right to refuse 
 treatment and to discontinue treatment, 
 including informing the individual's 
 physician and indicating when 
 individual cost-sharing requirements 
 end; and
 ``
            (III) the right to refuse to 
 participate in experimental research;
 ``
            (v) be informed by the supplier of 
 policies and expectations of the supplier 
 regarding patient conduct and responsibilities;
 ``
            (vi) be informed by the supplier about 
 treatment modalities and categories of 
 equipment relating to oxygen services for use 
 by the individual and offered by the supplier;
 ``
            (vii) be informed by the supplier of the 
 policies of such supplier regarding 24-hour on-
 call coverage;
 ``
            (viii) be informed by the supplier of the 
 financial responsibilities of the individual 
 with regard to such services, including the 
 number of months remaining within the rental 
 cap period under subparagraph
        (F) during which 
 the patient is responsible for the copayment 
 amount;
 ``
            (ix) be provided with the appropriate 
 gaseous or liquid oxygen equipment, supplies, 
 and services to ensure the mobility of the 
 beneficiary, as well as the clinically 
 appropriate amount of oxygen and oxygen related 
 equipment, supplies, and services as agreed 
 upon by the individual (or the individual's 
 representative), the supplier, and the 
 prescribing practitioner;
 ``
            (x) receive equipment that is maintained 
 to the guidelines of the manufacturer;
 ``
            (xi) have broken or faulty equipment 
 repaired or replaced in a timely manner;
 ``
            (xii) have oxygen or oxygen related 
 equipment or supplies delivered by the supplier 
 and to be contacted consistent with the 
 requirements of 

section 410.38 of title 42, 
 Code of Federal Regulations;
 ``
            (xiii) in the case of a supplier 
 involuntary discharging an individual--
 ``
            (I) receive from such supplier a 
 written notice that is provided to the 
 individual no later than 30 days in 
 advance of the involuntary discharge of 
 the individual; and
 ``
            (II) have such supplier--
 ``

    (aa) follow established 
 involuntary discharge 
 procedures; or
 ``

    (bb) in the case of an 
 immediate threat to the health 
 and safety of others, follow an 
 abbreviated involuntary 
 discharge procedure;
 ``
            (xiv) be assisted by the supplier in 
 obtaining the oxygen equipment and supplies 
 prescribed by the treating physician of the 
 individual when the individual is traveling;
 ``
            (xv) receive from the supplier oxygen 
 supplies, refills, and emergency back-up 
 equipment, as appropriate;
 ``
            (xvi) be informed of a plan by the 
 supplier in case of a power outage or other 
 natural emergency, so that the individual will 
 continue to receive the necessary oxygen 
 supplies and equipment; and
 ``
            (xvii) be informed by the supplier of--
 ``
            (I) any potential changes to the 
 equipment, supplies, or services being 
 furnished to the individual and the 
 right to consult with the prescribing 
 physician or practitioner regarding 
 such changes to ensure they are 
 appropriate and necessary and to be 
 informed of the exceptions, as 
 specified by the Secretary, when a 
 supplemental oxygen services supplier 
 may change the oxygen equipment of the 
 individual; and
 ``
            (II) the internal and external 
 grievance processes of the supplier (as 
 well as how to contact Medicare through 
 a hotline or beneficiary ombudsman), 
 which shall include the right of an 
 individual to file, personally or 
 through a representative of the 
 individual's choosing, an internal or 
 external grievance without retaliation 
 or denial of services from such 
 supplier.''.
 <all>