The U.S. Congress was not in session last week, but Senate Majority Leader Mitch McConnell (R-Kentucky) continued to work on the Senate Republican health care reform legislation.  Senator McConnell proposed:  (i) adding $45 billion to the bill to combat the opioid epidemic, up from $2 billion in the original legislation; and (ii) expanding Health Savings Accounts  for purposes of paying health insurance premiums.  Senator McConnell also suggested that if Senate Republicans cannot reach an agreement on health care reform legislation, Republicans and Democrats will likely have to work together to stabilize the health insurance markets.  Senator Ted Cruz (R-Texas) proposed to permit a health care insurer to sell health plans non-compliant with the Affordable Care Act (ACA), provided the insurer offered at least one plan that does comply with the ACA.  Senator Cruz’s proposal has been sent to the Congressional Budget Office, which will issue an analysis of the proposal’s financial and coverage effects.   On Sunday, President Trump again tweeted that if Senate Republicans cannot pass reform legislation, they should repeal the ACA and then work on a replacement.  Senator McConnell reportedly still hopes to have the full Senate vote on a health care reform bill before Congress’s August recess.

In January, CMS published a final rule implementing significant changes in the conditions of participation for home health agencies.  The final rule is available at and was to go into effect this week (Thursday, July 13).  Late last week CMS published a final rule delaying implementation of the final rule for six months until January 13, 2018.  A copy of this final rule is available at