2026-17767Proposed RuleWallet

FCC Wants Your Take on Rural Telehealth Tweaks

Published Date: 8/31/2026

Proposed Rule

Summary

In this document, the Federal Communications Commission (Commission) seeks comments on the scope of the similar service and rural area comparability requirements, comments on possible improvements to, or replacements of, our existing cost study method of determining rural telecommunications rates, comments on possible methods of promoting the use of lower-cost technologies intended to provide backup services, comments on a proposal to establish an eligible services list for the Rural Health Care (RHC) Program, comments on whether to adopt performance metrics to expedite the processing of RHC Program funding requests, and comments on whether to eliminate the approval requirement of evergreen contracts and an annual report requirement.

Analyzed Economic Effects

10 provisions identified: 9 benefits, 0 costs, 1 mixed.

Change 30% Speed Similarity Rule

The FCC is asking whether to keep or change the current rule that treats services within plus-or-minus 30% of a requested speed as “similar services.” They ask how to adjust prices when speeds differ and whether removing the 30% rule would let providers use more commercial rates to justify rural health-care rates.

Reduce Cost-Study Paperwork Burden

The FCC is seeking comment on reducing the heavy evidentiary requirements for Method 3 cost studies (company financials, cost allocations, audited statements, demand projections, and geographic density data) and on whether standardized templates could make cost studies less costly and faster to review.

Use Wholesale Rates As Alternatives

The FCC proposes allowing wholesale rates charged to other carriers to be used as a justification for rural Telecom Program rates, subject to documentation (invoices/contracts) and safeguards. The FCC also asks whether an added rate-of-return should be capped (for example, at 9.75%).

Permit Previously Approved Rates Permanently

The FCC is asking whether the temporary waivers that let providers rely on previously approved rates (waivers used for funding years 2024–2027) should be made permanent, and whether limits (for example, how recent an approved rate must be or time limits on continued reliance) are needed.

Allow Rate Projections for Different Bandwidths

The FCC seeks comment on allowing providers to use rate projections—interpolation or extrapolation—based on approved rates to justify rural rates at different bandwidths, and whether projections should be limited (for example to interpolation, or to rates approved within the past two years).

Limit Support For High-Cost Backup Services

The FCC asks whether the RHC Program should distinguish primary vs. secondary (backup) services and limit support for secondary services to lower-cost technologies or cap secondary service cost/performance to the primary service, so backup costs “reasonably reflect” secondary use.

Create RHC Program Eligible Services List

The FCC proposes adopting an official eligible services list for the RHC Program (modeled on the E-Rate list) to clarify which telecommunications, broadband services, and equipment are supported, and asks whether updates should be made as-needed with delegation to the Wireline Competition Bureau.

Adopt Application Processing Targets

The FCC is considering performance metrics to speed RHC Program application processing, including adopting a September 1 target (used for E-Rate) to issue funding commitments or denials for 'workable' requests, or another deadline with exceptions for complex cases.

Remove Evergreen Contract Approval Requirement

The FCC asks whether to eliminate the current rule that requires USAC to approve multi-year 'evergreen' contracts (Sec. 54.622(i)(3)) before applicants can use the competitive-bidding exemption, following the E-Rate approach where USAC approval is not required.

Propose Deleting HCF Annual Report

The FCC tentatively proposes deleting the Healthcare Connect Fund (HCF) annual report requirement (Sec. 54.618) that currently requires each HCF applicant to file a report by September 30 for the preceding funding year; the FCC notes HCF accounted for 56.8% of RHC funding commitments in funding year 2024.

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Key Dates

Published Date
Effective Date
Comments Due
8/31/2026
9/30/2026
10/30/2026

Department and Agencies

Department
Independent Agency
Agency
Federal Communications Commission
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