Program Overview
The Federal Rural Health Transformation Program (RHTP), authorized by the One Big Beautiful Bill Act, is a $50 billion initiative funding state-led transformation of rural health systems from FY2026 to FY2030. The program is currently in the application phase, with major focus areas including hospital stabilization, workforce development, technology advancement, and improving healthcare access. States must submit comprehensive transformation plans, meet defined milestones, and adhere to annual reporting and compliance requirements to participate. Current structured plan tracks 10 key initiatives and 11 strategic goals.
Updated
County-level estimates averaged across Federal — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
46,345,066 rural residents
AI source: US - 2025 - Accessing Funding for Capital Projects in Rural Healthcare.pdf
AI auto-updated May 8, 2026
API refreshed May 8, 2026
Centers for Medicare & Medicaid Services (CMS)
Due Nov 5, 2025
9 related documents
US - 2026 - Federal August 2025 RHTP Summary
Merged from duplicate US federal award
As of April 2026, the Federal Rural Health Transformation Program (RHTP) remains in the planning phase. The NOFO and application periods are set for Fall 2025 with awards to be announced at the end of 2025; no states have received funding or begun implementation yet.
The Federal RHTP strategy empowers states to create and implement comprehensive rural health transformation plans supported by $50 billion in federal funding over FY2026–FY2030. States must submit a one-time application detailing measurable, evidence-based initiatives that address access, workforce, technology, innovative care models, and financial stability, with annual milestones and CMS reporting requirements ensuring accountability and sustainability.
Model
Federally funded, state-led transformation requiring state-developed, multi-year rural health plans focused on data-driven, technology-enabled, and partnership-based interventions for sustainable rural healthcare delivery and measurable outcome improvements.
Key Initiatives
Timeline: FY2026–FY2030 (one-time state application due in 2025; annual progress reporting required)
Reference: Senators Call 50B Rural Health Fund Better Target Small Providers Relax Spending Link: https://www.fiercehealthcare.com/providers/senat ors-call-50b-rural-health-fund-better-target-sma ll-providers-relax-spending
Reference: MD, urging targeted adjustments to the Rural Health Transformation Link: https://www.beckershospitalreview.com/finance/se nators-warn-rhtp-may-disadvantage-independent-ru ral-hospitals/
Reference: Governor Morrisey Announces 24 Million Investment Expand Worksite Clinics Across West Link: https://governor.wv.gov/article/governor-morrise y-announces-24-million-investment-expand-worksit e-clinics-across-west
US - 2026 - Federal RHTP Summary 2026-2030
Auto-grouped context match (54%)
US - 2026 - H.R. 1 Section 71401
Auto-grouped context match (53%)
US - 2026 - Federal Category B Funding For Provider Payments RHTP Summary
Auto-grouped context match (38%)
US - 2026 - Federal RHTP Guidance - April 2026
US - 2026 - RHT 50 State Spotlights
US - 2025 - RHT Program State Project Abstracts
US - 2026 - An Official RHTP Summary
US - 2026 - An Official Website Of The United States Government RHTP
Centers for Medicare & Medicaid Services (CMS)
Due Nov 5, 2025
1 related document
US - 2026 - An Official RHTP Summary
Centers for Medicare & Medicaid Services (CMS)
Grouped files
1 related document
US - 2026 - An Official RHTP Summary
Centers for Medicare & Medicaid Services (CMS)
Grouped files
2 related documents
US - 2026 - RHT 50 State Spotlights
This document announces the FY2026 federal grant allocations for all 50 states under the CMS Rural Health Transformation Program, created by the One Big Beautiful Bill Act. Each state's RHTP award, totaling $10 billion across the US, supports rural health transformation initiatives spanning workforce, technology, population health, payment reform, and rural Medicaid.
This document compiles State-level abstracts from Rural Health Transformation Program (RHTP) applications submitted in December 2025. Each abstract summarizes the purpose, anticipated outcomes, major partners, and proposed program activities to be implemented with RHTP funds under the federal initiative. The document presents illustrative budgets, details of transformation plans, and a wide array of strategic approaches but is intended for public information and does not reflect final awards.
This letter presents bipartisan Senate support for improving implementation of the Rural Health Transformation Program (RHTP). Senators urge CMS to enhance flexibility, prioritize direct and equitable funding for rural hospitals and clinics, and remove barriers to infrastructure investments and IT modernization. The recommendations aim to ensure RHTP fulfills its promise to strengthen rural health care in underserved communities.
Core Initiatives
This draft CMS webinar provides detailed guidance on RHT Program state-level annual and quarterly reporting requirements. It outlines program timelines, required templates, the rescoring process for funding decisions, and the shift from Excel to a web-based reporting tool for states. No specific state- or initiative-level data is included, as this is a general federal instructional document.
The document establishes the Rural Health Transformation Program (RHTP), a $50 billion initiative appropriated for FY2026-2030. It outlines state eligibility requirements, transformation plan components, authorized activity types, milestones, the distribution and use of funds, and financial provisions. The program's primary focus is on rural health systems, with substantial emphasis on hospitals, technology, workforce, and access.
This fact sheet provides guidance on allowable and unallowable uses of Category B Provider Payments under the Rural Health Transformation Program. It outlines restrictions, sustainability requirements, and the 15% cap on Category B funding, as well as allowable example expenditures tied to state RHT transformation plan initiatives. The document clarifies payment models and directs states to ensure RHTP funds do not duplicate existing programs.
This document provides an overview of the Rural Health Transformation Program (RHTP), a $50 billion initiative created by the One Big Beautiful Bill Act to transform care and improve outcomes in rural communities. It summarizes eligible use of funds, program strategic goals, and application requirements, and provides a timeline for application and awardee selection. Key goals include prevention and chronic disease management, workforce development, behavioral health, and technology advancement.
This policy paper analyzes capital access challenges facing rural hospitals and other rural health facilities. It presents an overview of major capital funding programs and historical trends, emphasizing the complexity of blended financing and persistent access barriers. The report highlights the importance of technical assistance, partnerships, and varied funding streams for sustaining and modernizing rural healthcare infrastructure.
Core Initiatives
Reference: Senators Call 50B Rural Health Fund Better Target Small Providers Relax Spending Link: https://www.fiercehealthcare.com/providers/senators-call-50b-rural-health-fund-better-target-small-providers-relax-spending
Reference: MD, urging targeted adjustments to the Rural Health Transformation Link: https://www.beckershospitalreview.com/finance/senators-warn-rhtp-may-disadvantage-independent-rural-hospitals/
Reference: Governor Morrisey Announces 24 Million Investment Expand Worksite Clinics Across West Link: https://governor.wv.gov/article/governor-morrisey-announces-24-million-investment-expand-worksite-clinics-across-west
FY2026
RHTP Launch
RHTP funding allocation begins for states.
↳ US - 2026 - Federal August 2025 RHTP Summary
2032-10-01
Return of Unused Funds
Any unused RHTP funds leftover as of this date will be returned to the Treasury.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2032-09-30
Final Expenditure Deadline
All RHTP funds must be expended by September 30, 2032.
↳ US - 2026 - H.R. 1 Section 71401
2031-02-27
Final Report Due
Overall, cumulative program report covering FY26 to FY31 is due.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
2030
Program Funding End
RHTP federal funding runs through FY2030.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2028-03-31
Unused Funds Redistribution
CMS will annually redistribute unused funds by this date.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2028-03-31
Redistribution Assessment Begins
CMS to determine unexpended/unobligated funds for redistribution annually beginning 2028.
↳ US - 2026 - H.R. 1 Section 71401
2028
Redistribution
Redistribution of unused state allotments for RHTP begins.
↳ US - 2026 - Federal August 2025 RHTP Summary
2027-09-30
Funds Expire for FY2026 Allotments
Funds distributed in FY2026 must be used by the end of FY2027.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2027-08-30
Annual Report #2 Due
Second annual report is due, covering the following 12-month reporting period.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
2026-Q1
Monitoring Begins
Program monitoring and support for awardees begins in Q1 2026.
↳ US - 2025 - RHT Program Overview
2026-11-29
Quarterly Report #1 Due
First quarterly report for the RHT Program is due.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
US canonical state summary updated: progressSummary updated · transformationStrategy updated · strategicGoals updated
US strategy refreshed: transformationStrategy updated
US progress refreshed: implementationPhase: LAUNCHED · progressSummary updated
US progress refreshed: implementationPhase: LAUNCHED · progressSummary updated
US progress refreshed: implementationPhase: PLANNING · progressSummary updated
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed.
2026 - Governor Morrisey Announces 24 Million Investment Expand Worksite Clinics Across West
2026 - MD, urging targeted adjustments to the Rural Health Transformation
US - 2026 - An Official RHTP Summary
Event Schedule
Event Schedule
Core Initiatives
The Rural Health Transformation Program (RHTP), a $50 billion initiative authorized by the One Big Beautiful Bill Act, aims to transform rural healthcare nationwide by supporting state-based innovation, sustainability, workforce development, care coordination, and technology advancement. The program will fund approved states from FY2026 to FY2030, with application and award timelines set for late 2025. Strategic goals include improving rural health access, fostering tech solutions, and enabling innovative care and workforce models.
Event Schedule
Core Initiatives
Event Schedule
Core Initiatives
2026 - ... access in rural Kansas, promote preventative healthcare, increase provider
2026 - Senators Call 50B Rural Health Fund Better Target Small Providers Relax Spending
2026 - ... Commerce Committee Chairman Brett Guthrie to Iowa for a tour and roundtable
2026 - Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz to
CT - 2026 - Notice of Funding Opportunity (NOFO): RHTP Question and Answer Round 2 (OHS)
Medicare Managed Care Manual Chapter 17, Subchapter B: Payment Principles for Cost-Based HMO/CMPs
Health Insurance Portability and Accountability Act of 1996 (Public Law 104–191)
ME - 2026 - Senators Collins and Bennet Urge CMS to Adjust RHTP Implementation
2026 · HTML
CO - 2026 - Bennet, Collins, Colleagues Press CMS for Greater Flexibility in RHTP Implementation
2026 · HTML
US - 2026 - Federal Department Of Health & CMS Manual System Human Services (DHHS) Pub 100-19 Demonstrations Centers For Medicare & Medicaid Services (CMS) Transmittal 13368 Date: August 15, 2
2026 · PDF
Federal Updated January 13, 2026 REQUIRED PRIOR AUTHORIZATION LIST As Defined In 42 CFR 414.234(c)(1) 1 HCPCS Description Effective Date 0F Lower Limb Prosthetics (LLP) Addition To
2026 · PDF
Revisions to the State Operations Manual (SOM) Appendix U - Religious Nonmedical Healthcare Institutions
2026 · PDF
HB 3066 - Health Care Workforce Training Commission; creating the Workforce Talent Recruitment Revolving Fund
2025-2026 · HTML
Medicare Claims Processing Manual Chapter 21 - Medicare Summary Notices
2025 · PDF
Chapter 3 Revisions (Segment 1) in Publication (Pub.) 100-08 Program Integrity Manual (PIM)
2025 · PDF
Changing the Frequency of No-Pay Medicare Summary Notice (MSN) Mailings from Every 90 Days to Every 120 Days (CR 13627, Transmittal 12718)
2024 · PDF
Revisions to the State Operations Manual (SOM) Appendix B – Home Health Agencies (Transmittal 219, April 12, 2024)
2024 · PDF
Federal State Operations Manual Appendix M - Guidance To Surveyors: Hospice - Table Of Contents (Rev. 222; Issued: 06-07-24) Transmittals For Appendix M Part I – Investigative Proc
2024 · PDF
Revisions to the State Operations Manual (SOM) Appendix G - Guidance for Surveyors: Rural Health Clinics (RHCs)
2024 · PDF
Updates of Chapters 4 and 8 in Publication (Pub.) 100-08, Including Point of Contact Clarification and Update to Statistical Sampling Terminology
2023 · PDF
Cessation of Use of MyMedicare.gov Web Address (CMS Manual System CR 12798 Transmittal 11509)
2023 · PDF
Masking the Medicare Beneficiary Identifier (MBI) on the Medicare Summary Notice (MSN) (Transmittal 11510, Change Request 12801)
2023 · PDF
Revisions to the State Operations Manual (SOM) Appendix M – Hospice (Transmittal 210, Feb. 3, 2023)
2023 · PDF
Federal Medicare Fee-For-Service Emergency-Related Policies And Procedures That May Be Implemented Without § 1135 Waivers NOTE: The Following Q&As Address Matters That, In The Even
2023 · PDF
Revisions to the State Operations Manual (SOM) Appendix L - Ambulatory Surgical Centers
2023 · PDF
Updates to Chapter 4 in Publication (Pub.) 100-08, Including Removal of Requests for Anticipated Payment (RAP) Suppressions and Updates to Exhibit 16 - Model Payment Suspension Let
2022 · PDF
Updates of Chapter 4 in Publication (Pub.) 100-08, Including Update to Medicare Program Integrity Contractor Investigative Timeliness Requirement, and Updates to Exhibit 5 - Backgr
2022 · PDF
Updates to Chapter 4 of Publication (Pub.) 100-08, to Include the Addition of a Congressional Inquiries Section, Updates to the Vetting Leads with CMS Process, and Various Other Up
2022 · PDF
Revisions to Appendix I – Survey Procedures for Life Safety Code Surveys
2022 · PDF
Federal State Operations Manual Appendix I – Survey Procedures For Life Safety Code Surveys (Rev. 209, 12-09-22) Transmittals For Appendix I I. Introduction II. The Survey Tasks Ta
2022 · PDF
Revisions to the State Operations Manual (SOM) Appendix L - Ambulatory Surgical Centers and Chapter 9 Exhibits – Exhibit 351
2022 · PDF
Updates to Chapter 4 of Publication (Pub.) 100-08 – Medicare Program Integrity Manual (Transmittal 10711, CR 12135, 04-01-2021)
2021 · PDF
Revisions to the State Operations Manual (SOM) Appendix Z - Emergency Preparedness
2021 · PDF
Federal Telehealth Network Grant Program | HRSA Skip To Main Content U.S. Department Of Health Human Services Health Resources Services Administration Call, Text, Or Chat The Mater
2020 · HTML
HHS Federal Rural Action Plan (2020)
2020 · PDF
Removal of Signature Line from Appeals Page of the Medicare Summary Notice (MSN) and MSN Envelope Correction
2020 · PDF
Removal of Signature Line from Appeals Page of the Medicare Summary Notice (MSN) and MSN Envelope Correction
2020 · PDF
CMS Manual System Transmittal 199: Revisions to State Operations Manual (SOM) Chapter 6 - Special Procedures for Laboratories and Chapter 9 Exhibits
2020 · PDF