The Council for Quality Respiratory Care (CQRC) has raised alarms about the Centers for Medicare & Medicaid Services’ (CMS) proposed return to competitive bidding for supplemental oxygen—a move that could jeopardize access for patients reliant on home oxygen therapy.
What’s at Stake?
As the DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) Competitive Bidding Program is poised for revival, CQRC warns that the updated methodology may replicate past pitfalls—resulting in below-market reimbursement, restricted access to critical oxygen supply modalities, and decreased availability for vulnerable Medicare beneficiaries CQRC+1.
Robin Menchen, newly appointed Chair of CQRC and CEO of Rotech Healthcare, voices the organization’s deep concern: prior rounds of competitive bidding fundamentally undermined patient access. CQRC appreciates CMS’s previous decision to pause the bidding program and presses for reforms that keep patient care, not cost-savings, at the center CQRCHME News.
The SOAR Act: A Lifeline for Patients?
To address these challenges, CQRC strongly supports the Supplemental Oxygen Access Reform (SOAR) Act (S. 1406/H.R. 2902), a bipartisan legislative effort to:
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Exclude supplemental oxygen from future competitive bidding rounds,
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Institute patient protections and fraud safeguards,
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Facilitate respiratory therapy access, especially in rural or underserved areas CQRC+1HME News.
CQRC and its partners plan to submit formal comments to CMS and advocate in Congress to ensure oxygen remains accessible and to preserve lessons from past bidding errors CQRC+1.
But There’s More to the Story
Not everyone aligns on the urgency of removing oxygen from competitive bidding. A recent JAMA Internal Medicine cohort study (2024) evaluated Medicare data between 2009 and 2015. It concluded that while competitive bidding significantly reduced costs, it did not impact oxygen prescription rates or patient outcomes for COPD patients—suggesting no clear harm to access or well-being PubMed.
Meanwhile, investigative reporting by ProPublica highlights a complicated alliance between oxygen companies and patients. Business groups and patient advocates are jointly pushing for the SOAR Act—raising critical questions about whether the move reflects patient needs, provider financial interests, or both. Notably, one academic author emphasized: “Competitive bidding saved taxpayers and patients hundreds of millions of dollars, without curbing their access to oxygen or hurting their health” ProPublica.
A High-Stakes Debate
On one side, there is a valid concern about access to oxygen therapy, especially complex modalities like liquid oxygen—which is vital for patients with advanced lung disease seeking independence and mobility Respiratory TherapyRare Disease Advisor.
On the other hand, objective data indicates competitive bidding can lower Medicare spending without compromising care. The questions at hand are:
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How to reconcile patient access and cost containment?
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Can the bidding model be redesigned to address access gaps?
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What safeguards and protections should accompany any future bidding rounds?
Final Thoughts
The proposed return of competitive bidding in 2025 presents a high-stakes moment for respiratory care in America. CQRC’s advocacy for the SOAR Act underscores the urgent need to weigh patient access and care quality alongside fiscal responsibility. Meanwhile, emerging studies provide critical data to inform the debate—but also spark friction among stakeholders.
As this unfolds, it will be essential for policymakers to examine both the evidence and the real-world implications on patient access when shaping the future of oxygen therapy reimbursement under Medicare.
Original Article from HME News: https://hme-business.com/cqrc-proposed-competitive-bidding-policies-could-hurt-patient-access-to-supplemental-oxygen/?spMailingID=167075&puid=2929959&E=2929959&utm_source=newsletter&utm_medium=email&utm_campaign=167075
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