FCC Publishes Rural Health Care Program Proposal in the Federal Register, Opening a Public Comment Period

The broadband and telecommunications links that let a rural clinic run a video visit or send imaging to a distant specialist are subsidized, in part, by a federal program most patients never see. That program's rulebook is now formally on the table. A Federal Communications Commission proposal to change how the Rural Health Care Program sets rates and processes applications has been published in the Federal Register, which starts the clock on a public comment period. As with any rulemaking, what is published is a proposal that seeks comment, not a settled change.

What the FCC published

On August 31, 2026, the Federal Register published a proposed rule from the Federal Communications Commission titled Promoting Telehealth in Rural America (WC Docket No. 17-310, FCC 26-54, published at 91 FR 55816). The document is the synopsis of the Commission's Third Further Notice of Proposed Rulemaking, which the Commission says it adopted on August 6, 2026 and released on August 7, 2026. Publication in the Federal Register is the procedural step that opens the formal public comment period. The notice seeks comment on possible changes to the Rural Health Care (RHC) Program; it does not adopt final rules.

What the Rural Health Care Program does

The Rural Health Care Program is one of the federal Universal Service Fund programs. It helps eligible rural health care providers obtain telecommunications and broadband internet services at reduced rates, which in turn supports the delivery of telehealth in remote communities. The Telecommunications Program, one part of the RHC Program, is built on Section 254(h)(1)(A) of the Communications Act of 1934, which the notice quotes as requiring that eligible providers receive service at rates that are reasonably comparable to rates charged for similar services in urban areas in that state, with support based on the difference between the rural and urban rates. How the Commission defines those comparisons drives how much support a provider receives.

What the notice asks

According to the Federal Register notice, the Third Further Notice groups its proposals into three areas and seeks comment on each. It poses questions rather than adopting rules:

• Support calculations in the Telecommunications Program: whether and how to define the scope of similar services and comparable rural areas, and how to lessen the burdens tied to cost studies and the evidentiary requirements proposed in the Second Further Notice of Proposed Rulemaking (FCC 23-64, published March 23, 2023).
• Supported services: ways to promote the use of lower cost backup services, and whether to establish an RHC Program eligible services list, described in the notice as similar in concept to the list used for the E-Rate program.
• Program processes: whether to adopt performance metrics for the processing of RHC Program applications, and whether to eliminate the Universal Service Administrative Company's approval of evergreen contracts and the rule requiring an annual report from entities that receive Healthcare Connect Fund Program support.

The Commission frames the common thread as reducing burdens and costs on program participants while protecting the limited resources of the Universal Service Fund by preventing waste, fraud, and abuse. Each item is a question for public comment, per the notice, and the specifics can change before the Commission issues anything final.

The funding year 2027 waiver and a push toward permanence

The notice explains that an accompanying Order again waives the Commission's cost justification rule to permit the use of previously approved rural rates for funding year 2027, extending an approach the notice describes as previously covering funding years 2024 through 2026. Alongside that, the Commission seeks comment on a proposal that, in its words, would have the practical effect of making these rule waivers permanent, and it asks how the use of previously approved rates would work on a permanent basis. The waiver for 2027 is part of the item's Order; making the approach permanent is a proposal in the notice that only seeks comment.

What this means for rural telehealth

The RHC Program pays for the connectivity layer beneath rural telehealth: the broadband and telecommunications links that let clinics and hospitals in remote areas run video visits, transmit imaging, and connect to larger health systems. Clearer rules on how rural rates are set, a defined list of eligible services, and fewer repetitive cost justifications could make the subsidy easier for small rural providers to use and could speed application processing. The Commission presents the changes as administrative and as a way to better administer limited funding rather than as an expansion of the program. Whether any of it takes effect, and in what form, depends on the comment record and a later Commission decision.

How and when to comment

According to the notice, comments are due on or before September 30, 2026 and reply comments are due on or before October 30, 2026. Filings are made in WC Docket No. 17-310, and the notice directs electronic filers to the Commission's Electronic Comment Filing System. This is general information about a pending federal proceeding, not legal advice. Providers or others who want to file should consult the Commission's published notice and filing rules or a qualified adviser before submitting formal comments.

Limits of what is known

This is a proposal at the comment stage. As of publication the Commission had sought comment but had not adopted final rules on the questions in the notice, and the outcome could narrow, change, or drop any individual proposal. The dollar figures, eligibility rules, and timelines that ultimately apply to the Rural Health Care Program will be set by whatever the Commission adopts later, informed by the record built during the comment period described above.