Action by: the Commission. Adopted: 2019-08-01 by R&O. (FCC No. 19-78). WCB. FCC-19-78A1.pdf

Nearly 60 million people—roughly 1 out of every 5 Americans—live in a rural area. Telehealth services are one important solution to the challenge of health care access in rural areas by connecting rural patients with general physicians and medical specialists located outside the patients’ communities. The Commission promotes telehealth in rural areas through the Rural Health Care Program (RHC Program or Program), which provides financial support to help rural health care providers obtain broadband and other communications services at discounted rates. These services are in turn used by health care providers to offer telehealth to patients living in and around the communities they serve.

As the demand for robust broadband has increased throughout the country, the RHC Program has witnessed a dramatic increase in health care provider participation. Even with the Commission increasing the RHC funding cap last year by more than $170 million over the prior $400 million funding cap to account for inflation, demand continues to stress the RHC Program. This creates a challenge for program administration, leading to uncertainty among participants as to the status of their funding requests and complicating the planning of upgrades and existing service relationships. This increased demand and resulting administrative challenges required us to take a closer look at whether the current rules and procedures are cost-effective and efficient and adequately protect the Universal Service Fund against waste, fraud, and abuse. Accordingly, in this Report and Order, after reviewing the record, Federal Communications Commission FCC 19-78 3 we adopt a number of the proposals made in the 2017 Promoting Telehealth Notice and Order3 to reform the RHC Program rules to promote transparency and predictability, and further the efficient allocation of limited RHC Program resources.