On January 27, 2023, the FCC released an Order on Reconsideration, Second Report and Order, Order, and Second Further Notice of Proposed Rulemaking on the Rural Health Care (“RHC”) Program, which was adopted at the January Open Meeting.
Order on Reconsideration
In the Order on Reconsideration, the FCC reviewed several provisions of the 2019 Promoting Telehealth Report and Order and adopted the following changes:
- Restored the rate mechanisms for calculating rural and urban rates that existed prior to the Promoting Telehealth Report and Order
- Upheld the Promoting Telehealth Report and Order’s rule changes regarding what services are similar to one another
- Maintained the rurality tiers adopted in the Promoting Telehealth Report and Order, which now apply only to the prioritization of funding requests
- Maintained the internal cap and funding prioritization systems and invoice certification requirements from the Promoting Telehealth Report and Order
Second Report and Order
In the Second Report an Order, the FCC adopted new rules for the RHC Program, including:
- Amending the Telecom Program invoicing process to harmonize the RHC invoicing process across the Telecom Program and the Healthcare Connect Fund (“HCF”) Program
- Amending the funding cap and prioritization rules to limit the application of the internal cap and prioritize heath care providers’ current year financial need over their future year need when the internal cap is exceeded
- Makes minor changes to the RHC Program rules regarding the number of health care provider types that are eligible in the RHC Program
The Order dismisses two Applications for Review on the implementation of the Rates Database as moot given the rules adopted in the Order on Reconsideration.
Second Further Notice of Proposed Rulemaking
The Second FNPRM seeks comment on several proposals to modify the RHC Program, including:
- Modifications to the three rural rate determination methods in the Telecom Program, including changes to the market-based approach of Methods 1 and 2 and new evidentiary requirements for justifying cost-based rates under Method 3
- Simplifying urban rates by eliminating the “standard urban distance” distinction and seeking comment on sources for urban rates and the urban rate rules generally
- Reinstating the cap on support for satellite services that the FCC eliminated when it adopted the Rates Database and amending HCF Program rules to make equipment supporting Telecom Program services eligible
- Adopting a conditional eligibility process to allow entities that will be eligible health care providers in the future to engage in competitive bidding and file Requests for Funding before they become eligible
- Aligning the deadline to request a Service Provider Identification Number change with the invoice filing deadline and seeking comment on a post-commitment process to amend evergreen contract dates
- Revisions to FCC Form 466 to improve the quality of Telecom Program data
Comments will be due 30 days after the date of publication in the Federal Register.
Reply comments will be due 60 days after the date of publication in the Federal Register.
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