The FCC proposes an overhaul of its Rural Health Care program — six questions from how rates are calculated to creating an eligible services list — Federal Register (August 2026)
The Federal Communications Commission issued a third further notice of proposed rulemaking seeking comment on the Rural Health Care program, which supports telecommunications costs for rural health providers. It asks about the cost study method used to set rural rates, creating an eligible services list, and five other questions. Comments are due September 30, 2026 and reply comments October 30, 2026.
Document overview (primary data)
- Document typeProposed rule
- AgencyFederal Communications Commission
- Citation91 FR 55816
Key points
- The FCC published a third further notice of proposed rulemaking on its Rural Health Care program (published August 31, 2026; WC Docket No. 17-310, FCC 26-54).
- Six questions: scope of rate comparability, improving or replacing the cost study method, lower-cost backup technologies, an eligible services list, performance metrics for faster processing, and eliminating evergreen contract approval and an annual report.
- The questions split between the core of how support is calculated and lightening the administrative work of applying.
- An eligible services list would raise predictability and consistency while also drawing a boundary around what falls outside.
- Comments are due September 30, 2026 and reply comments October 30, 2026.
1The connectivity bill underneath telehealth
Before remote care can work in a rural area, a stable connection has to exist. In sparsely populated places circuit rates tend to run higher than in cities, and health providers cannot always absorb the difference. The Rural Health Care program run by the Federal Communications Commission exists to close that gap by supporting the telecommunications costs of rural health providers.
The third further notice published here considers changes across the program and seeks comment on six questions.
2What is being asked
| Question | What is at issue |
|---|---|
| Rate comparability | How broadly the similar service and rural area rate comparability requirements should apply |
| Cost study method | Whether to improve the existing cost study method for determining rural telecommunications rates, or replace it |
| Backup service | How to promote the use of lower-cost technologies intended to provide backup services |
| Eligible services list | Whether to establish an eligible services list for the program |
| Faster processing | Whether to adopt performance metrics to expedite processing of funding requests |
| Procedural relief | Whether to eliminate the approval requirement for evergreen contracts and an annual report requirement |
Laid out together, the questions fall into two directions. One concerns the core of how support is calculated; the other concerns lightening the administrative work of applying and being approved. Support programs often go unused not because of design flaws but because applying is heavy. Adopting performance metrics and dropping an annual report speak directly to the second.
3Proposing an eligible services list
Of the six, the one most likely to change the character of the program is the eligible services list. Setting out in advance what qualifies for support raises predictability for applying providers and reduces variation in how reviewers decide. It also draws a boundary: a service not on the list falls outside.
In a field where the technology moves quickly, the merits and costs of holding a fixed list are among the things this comment cycle will test.
4The window for comment
The document is published as a proposed rule, with comments due September 30, 2026 and reply comments due October 30, 2026, under WC Docket No. 17-310. Of the 6,830 Federal Register documents this site holds as of 2026-09-02, 460 are proposed rules — fewer than the 5,384 notices and 920 rules.
Their significance is that they mark the stage at which outside views can still enter the design before anything is settled, which for affected parties is the point of maximum leverage.
Why it matters
Debate about telehealth gravitates toward devices and services, but the design question of who bears the underlying connectivity cost is what is on the table here. An eligible services list and the removal of an annual report would bear directly on the day-to-day work of rural providers and their carriers.
FAQ
What is the Rural Health Care program?
What has been decided?
Sources (primary)
Source: Federal Register (federal documents, public domain). Links go to the official site.