Federal

US - 2026 - RHT Program Overview

US - 2026 - RHT Program Overview

CMS announced FY2026 RHTP funding awards to all 50 states ranging from $147 million to $281 million each. The program supports rural health transformation through significant federal investment focused on workforce, technology, prevention, and care innovation. Event schedule: - CMS Announcement of RHTP Awards - 12/29/2025 - ET - CMS Press Release - RHTP Award Decisions Deadline - 12/31/2025 - ET - CMS

CMS released a Notice of Funding Opportunity for the $50 billion Rural Health Transformation Program, allocating $10 billion annually from 2026 to 2030. Funding is split equally between states with approved transformation plans and discretionary CMS allocations, enabling states to invest in rural healthcare improvements. Event schedule: - NOFO Release Date - 09/15/2025

The NRHA welcomes the release of the RHTP NOFO, noting the unprecedented $50 billion federal investment aimed at prevention, access, workforce, technology, and care innovation in rural health. It emphasizes that while significant, the one-time funding needs to be paired with long-term policy reforms to ensure the sustainability of rural providers.

This CMS guidance defines the scope, definitions, and application of Category E (Workforce) for Rural Health Transformation Program funding. It clarifies eligible workforce recruitment and retention activities, eligibility standards for various roles such as LPNs, PMHNPs, community paramedics, CHWs, and doulas, and the applicability and enforcement of 5-year rural service commitments. States are provided with decision criteria, common questions, and requirements for tracking, enforcing, and forgiving service obligations.

This fact sheet summarizes allowable and unallowable uses of Rural Health Transformation Program Category J funds for capital expenditures and infrastructure in rural health facilities. Examples of eligible expenses include minor renovations, equipment upgrades, repairs, accessibility improvements, and safety/security enhancements. Major construction or cosmetic upgrades are explicitly excluded, and total Category J spending cannot exceed 20% of a state’s RHTP award per budget period.

This summary outlines the Rural Health Transformation Program (RHTP) established by the OBBBA, appropriating $50 billion in federal funding to all 50 states from FY2026 to FY2030. It describes the distribution mechanism, allowable activities, and strategic goals of RHTP, designed to stabilize and strengthen rural hospitals, support workforce, and promote technology-driven solutions for rural communities.

This GAO report summarizes the implementation and initial federal funding (budget period 1: $10 billion) of the Rural Health Transformation Program, with $100 million in baseline funding to each state and additional workload funding based on rural population and program scoring. CMS established the Office of Rural Health Transformation to direct oversight, technical assistance, and post-award monitoring. Key goals include technology adoption for chronic disease management, workforce recruitment, and policy actions such as nutrition and school fitness initiatives. Monitoring activities and audit requirements are being developed and will be fully implemented by the end of budget period 1, with future funding tied to progress and compliance. Key contacts: Leslie V. Gordon gordonlv@gao.gov; Sarah Kaczmarek Media@gao.gov; David A. Powner CongRel@gao.gov Event schedule: - Budget Period 1 Award Announcement - 12/29/2025 - Budget Period 1 Revision Deadline - 01/30/2026 - Budget Period 2 Funding Determination - 08/01/2026

This independent analysis estimates that the Rural Health Transformation Program (RHTP) totals $50 billion over 5 years, with allocations based on a baseline formula and rural facility/population scoring. Estimated funding is not well aligned with rural health needs, with states facing high rural mortality receiving less per rural resident. RHTP funding is much less than projected Medicaid cuts, and only a handful of states may see allocations sufficient to offset those reductions. States with greater losses of rural hospital beds and higher rural populations do receive more funding, though the margin is modest. Event schedule: - , 2025 - December 4 - By: - Date: , 2025 - December 4 - Re: Response to Request for Analysis of the Rural Health Transformation Program - , 2026 - August 28 - Policy - , 2026 - August 17 - Policy - , 2026 - June 22 - Policy - , 2026 - June 8 - Policy - , 2026 - May 6

This report provides a quarterly snapshot of RHTP obligated funds for program operations, administration, and initial initiative launches by state in the first budget period concluding July 2026. No explicit sub-awards to hospitals or other recipients are reported at this level. CMS will continue to update these obligations on a quarterly basis. Event schedule: - Year 1 Annual Report Close - 07/31/2026 - Next Quarterly Report Submission - 11/30/2026

This 2026 State Programmatic Snapshots reference document summarizes the funding and initiative focus areas for the first two RHTP budget periods (2025-2027) in Alabama, Alaska, Arizona, and Arkansas. It details each state's major rural transformation strategies, technical scoring under the program, and policy action commitments relevant to ongoing federal rural health reform. Award figures reflect total state allocations, not sub-recipient awards.

The Centers for Medicare & Medicaid Services (CMS) awarded $10 billion in Year 2 funding to all 50 states through the Rural Health Transformation Program (RHTP), as part of a $50 billion, five-year initiative. RHTP aims to strengthen rural healthcare by improving access, workforce development, technology, care innovation, and system sustainability. Each state receives $100 million annually as baseline funding, with additional funds distributed based on state-specific factors and plan implementation progress. States must report annually to CMS, and funding is dynamic, determined by program-defined criteria.