# FCC Proposed Rule on the Rural Health Care Program: A Brief for Outpatient Practices

> The FCC's August 31, 2026 proposed rule seeks comment on rural rate comparability, cost studies, backup services, an RHC eligible services list, processing metrics and evergreen contract approvals.

iPMS Practice Desk · 2026-10-04 · https://blog.myipms.app/fcc-proposed-rule-on-the-rural-health-care-program-a-brief-for-outpatient-practi

The Federal Communications Commission (FCC) published a proposed rule titled "Promoting Telehealth in Rural America" in the Federal Register on August 31, 2026, as document 2026-17767 [1]. The notice concerns the Rural Health Care (RHC) Program, and in its summary the Commission states that it seeks comments on each topic rather than announcing changes already adopted [1]. This brief covers what the notice asks about, who is likely to be touched by it, the dates the summary provides, and what a practice can verify now [1].

## What the proposed rule does

The summary lists six areas on which the Commission seeks comment [1]:

- **Similar service and rural area comparability:** comment on the scope of these two existing requirements [1].
- **Rural telecommunications rates:** comment on possible improvements to, or replacements of, the existing cost study method the Commission uses to determine rural telecommunications rates [1].
- **Backup services:** comment on possible methods of promoting the use of lower-cost technologies intended to provide backup services [1].
- **Eligible services list:** comment on a proposal to establish an eligible services list for the RHC Program [1].
- **Processing of funding requests:** comment on whether to adopt performance metrics to expedite the processing of RHC Program funding requests [1].
- **Evergreen contracts and annual report:** comment on whether to eliminate the approval requirement for evergreen contracts and an annual report requirement [1].

The eligible services list is the only item the summary frames as a specific proposal; the others are framed as questions, possible options or possible improvements [1]. The summary does not define "similar service," "rural area comparability" or "evergreen contracts," and it does not describe how the current requirements work in practice [1].

## Who it affects

The notice is directed at the RHC Program, so its direct relevance is to entities that take part in that program [1]. The summary does not set out eligibility criteria for the program, so whether a given independent practice participates should be confirmed against the practice's own program records rather than inferred from this notice [1]. For a participating practice, the items closest to day-to-day administration are the processing of funding requests, the approval requirement for evergreen contracts and the annual report requirement, because each concerns a step in program administration [1]. The summary does not state which entities file the annual report [1].

The FCC notice is separate from the Medicare rules that the Centers for Medicare & Medicaid Services (CMS) published in the same month, and its summary makes no reference to Medicare payment [1, 2, 3]. Those CMS rules include the FY 2027 inpatient prospective payment system final rule, which addresses acute care hospitals, long-term care hospitals, graduate medical education and quality programs, and in which ONC adopts certain health IT standards on behalf of HHS [2]. They also include the FY 2027 hospice final rule, which updates hospice wage index and payment rates and finalizes changes to the Hospice Quality Reporting Program [3].

## Dates that matter

- **Publication:** the proposed rule appeared in the Federal Register on August 31, 2026 [1].
- **Comment and reply comment deadlines:** the summary does not state them, so they need to be read from the full document at its Federal Register page [1].
- **Effective date:** the summary gives none, consistent with a notice that seeks comment rather than adopting changes [1].
- **Related CMS rules, for context:** the hospice final rule was published on August 3, 2026, and the inpatient prospective payment system final rule on August 4, 2026 [2, 3].

## What a practice should check

- Whether the practice currently receives support through the RHC Program, and for which services, since the proposed eligible services list would bear on that question [1].
- Which of the practice's telecommunications contracts are evergreen contracts subject to the current approval requirement, since the Commission asks whether to eliminate that requirement [1].
- Whether any RHC funding requests are pending, since the notice asks about performance metrics for processing them [1].
- What backup connectivity the practice relies on, since the notice asks about promoting lower-cost backup technologies [1].
- Whether the practice has obligations under the annual report requirement that the Commission asks about eliminating [1].
- The comment and reply comment deadlines in the full Federal Register document, if the practice or its representatives intend to file comments [1].

## Limitations

This brief relies on the Federal Register summary of document 2026-17767, not on the full text of the notice [1]. The full document may contain specific proposals, definitions, deadlines and questions that the summary omits [1]. The summary gives no figures on program funding, participation or rates, so none are reported here [1]. Because the notice seeks comment, any eventual rule may differ from the options it describes [1].

## References

1. federalregister.gov. Promoting Telehealth in Rural America. Accessed October 3, 2026. https://www.federalregister.gov/documents/2026/08/31/2026-17767/promoting-telehealth-in-rural-america
2. federalregister.gov. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; Other Policy Changes; and Adoption of Updated Versions of Certain Health Information Technology Standards. Accessed October 3, 2026. https://www.federalregister.gov/documents/2026/08/04/2026-15833/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and
3. federalregister.gov. Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements. Accessed October 3, 2026. https://www.federalregister.gov/documents/2026/08/03/2026-15686/medicare-program-fy-2027-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting