H.R. 1, passed in July 2025, established the Rural Health Transformation (RHT) Program—a $50 billion grant program that will provide $10 billion in grants to states annually from 2026 to 2030 to support and improve rural health care access, delivery, and outcomes. The Centers for Medicare & Medicaid Services (CMS) published a new web page, including a presentation and FAQs, that outline the RHT Program’s strategic goals, approved uses of funds, and application timeline.
Half of the RHT Program funds will be distributed equally to all states with approved applications. The other half of the funds “will be allocated by CMS based on a variety of factors including rural population, the proportion of rural health facilities in the State, the situation of certain hospitals in the State, and other factors to be specified by CMS in the” Notice of Funding Opportunity (NOFO). The FAQs note that there “are no specific restrictions in the NOFO on which provider organizations can effectuate impact on rural communities and residents” in response to a question as to whether organizations eligible for funding need to be located in rural areas.
The NOFO, which includes application instructions, was released on September 15. A state’s application must include information on its rural health needs and target population, goals and strategies, proposed initiatives and use of funds, implementation plan and timeline, stakeholder engagement plan, metrics and evaluation plan, and sustainability plan.
CMS will host introductory webinars for program applicants on September 19 and September 25. The agency will accept and respond to stakeholder questions throughout October. States must submit their application by November 5 and also have the option to submit a letter by September 30 stating their intent to apply. CMS will make award decisions by December 31.