Application period opens for the Rural Health Transformation Program
On Sept. 15, CMS opened the application period and published a Notice of Funding Opportunity (NOFO) for the Rural Health Transformation (RHT) Program. The RHT Program was established by the One Big Beautiful Bill and will provide $50 billion to states over five years to “transform the existing rural health care infrastructure and build sustainable health care systems that expand access, enhance quality of care, and improve outcomes for patients.”
Half of the $50 billion funding will be allocated evenly among states with approved applications, and the other half will be allocated to states based on factors described in the NOFO, including the rural characteristics of the state, initiatives proposed by the state in its application, and state policies in effect or which the state commits to changing.
The AMA has concerns about some state policies promoted in the NOFO including expanded scope of practice for physician assistants, nurse practitioners, pharmacists, and dental hygienists; deregulation of short-term limited duration insurance plans; and mandatory CME on nutrition for physicians. Other state policies promoted in the NOFO include adoption of interstate licensure compacts; Medicaid coverage and licensing pathways for remote patient care; repeal of certificate of need (CON) laws; prohibitions on SNAP benefits for unhealthy foods; and reestablishment of the Presidential Fitness Test. The NOFO also encourages states to propose initiatives that address population health clinical infrastructure, health and lifestyle, rural provider strategic partnerships, emergency medical services, workforce recruitment, Medicaid provider payment incentives, dual eligibles, remote care services, data infrastructure, and consumer-facing technology. RHT Program funding may not be used as payment for services already reimbursed by health insurance, Medicaid, CHIP or Medicare.
To qualify for funding, states must apply by Nov. 5, 2025. CMS will announce funding awards by Dec. 31, 2025.
A summary of the RHT Program is available on the AMA website (PDF). The AMA Advocacy Resource Center is working closely with state and specialty medical associations to inform state application processes.
More articles in this issue
- Sept. 19, 2025: Advocacy Update spotlight on extension of enhanced premium tax credits
- Sept. 19, 2025: Medicare Payment Reform Advocacy Update
- Sept. 19, 2025: National Advocacy Update
