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CQRC commends new fraud report, offers SOAR Act as reform

CQRC commends new fraud report, offers SOAR Act as reform

WASHINGTON – The Council for Quality Respiratory Care (CQRC) commends the House Committee on Energy and Commerce for releasing a report on emergent fraud trends impacting Medicare and Medicaid services across the nation. The report emphasizes the need for innovative tools and technology-based solutions to improve fraud detection and mitigation, and the need to move away from “pay and chase.” The CQRC points out that the Supplemental Oxygen Access Reform (SOAR) Act, H.R. 2902/S. 1406, would help the government reach that goal by, among other things, requiring the Centers for Medicare & Medicaid Services (CMS) to adopt a standardized electronic template that it says would help prevent fraudulent or abusive claims by providing the information needed to establish medical necessity before claims are paid. “The electronic template would improve clarity and accuracy in the Medicare review process, reducing improper payments linked to the current order process and contractors’ reliance on physician chart notes, thereby preventing fraud before it occurs,” the organization states. “In 2025, HHS estimated improper payments for oxygen cost the government approximately $80 million.” The CQRC urges the Energy and Commerce Committee to pass the SOAR Act. Previously, the CQRC commended the committee for holding a Jan. 8 legislative hearing on “Improving Medicare Payment Policies for Seniors” that highlighted the SOAR Act as reform for addressing barriers to care for individuals who need medical oxygen to manage their respiratory and pulmonary diseases.

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