[Federal Register Volume 91, Number 167 (Monday, August 31, 2026)]
[Proposed Rules]
[Pages 55816-55825]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2026-17767]
=======================================================================
-----------------------------------------------------------------------
FEDERAL COMMUNICATIONS COMMISSION
47 CFR Part 54
[WC Docket No. 17-310; FCC No. 26-54; FR ID 364116]
Promoting Telehealth in Rural America
AGENCY: Federal Communications Commission.
ACTION: 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.
[[Page 55817]]
DATES: Comments are due on or before September 30, 2026 and reply
comments are due on or before October 30, 2026. If you anticipate that
you will be submitting comments but find it difficult to do so within
the period of time allowed by this document, you should advise the
contact listed below as soon as possible.
ADDRESSES: Pursuant to Sec. Sec. 1.415 and 1.419 of the Commission's
rules, 47 CFR 1.415, 1.419, interested parties may file comments and
reply comments on or before the dates indicated in the DATES section of
this document. You may submit comments identified by WC Docket No. 17-
310, by any of the following methods:
Electronic Filers: Comments may be filed electronically
using the internet by accessing the ECFS: https://www.fcc.gov/ecfs/.
Paper Filers: Parties who choose to file by paper must
file an original and one copy of each filing.
[cir] Filings can be sent by hand or messenger delivery, by
commercial courier, or by the U.S. Postal Service. All filings must be
addressed to the Secretary, Federal Communications Commission.
[cir] Hand-delivered or messenger-delivered paper filings for the
Commission's Secretary are accepted between 8:00 a.m. and 4:00 p.m. by
the FCC's mailing contractor at 9050 Junction Drive, Annapolis
Junction, MD 20701. All hand deliveries must be held together with
rubber bands or fasteners. Any envelopes and boxes must be disposed of
before entering the building.
[cir] Commercial courier deliveries (any deliveries not by the U.S.
Postal Service) must be sent to 9050 Junction Drive, Annapolis
Junction, MD 20701.
[cir] Filings sent by U.S. Postal Service First-Class Mail,
Priority Mail, and Priority Mail Express must be sent to 45 L Street
NE, Washington, DC 20554.
People with Disabilities: To request materials in
accessible formats for people with disabilities (Braille, large print,
electronic files, audio format), send an email to [email protected] or
call the Consumer & Governmental Affairs Bureau at (202) 418-0530.
FOR FURTHER INFORMATION CONTACT: Kate Dumouchel,
[email protected], Wireline Competition Bureau, 202-418-7400 or
TTY: 202-418-0484. Requests for accommodations should be made as soon
as possible in order to allow the agency to satisfy such requests
whenever possible. Send an email to [email protected] or call the Consumer
and Governmental Affairs Bureau at (202) 418-0530.
SUPPLEMENTARY INFORMATION: This is a synopsis of the Commission's
Promoting Telehealth in Rural America, Third Further Notice of Proposed
Rulemaking (FNPRM) in WC Docket No. 17-310; FCC No. 26-54; adopted
August 6, 2026 and released August 7, 2026. The full text of this
document is available for public inspection during regular business
hours at Commission's headquarters 45 L Street NE, Washington, DC 20554
or at the following internet address: https://docs.fcc.gov/public/attachments/FCC-26-54A1.pdf.
Synopsis
I. Third Further Notice of Proposed Rulemaking
In this FNPRM, we seek comment on several possible RHC Program
improvements grouped within three distinct areas: Telecommunications
(Telecom) Program support calculations, RHC Program supported services,
and RHC Program processes. For Telecom Program support calculations, we
seek comment on whether and how we should define the scope of ``similar
services'' and ``comparable rural areas,'' and on ways to lessen the
burdens resulting from cost studies and the associated evidentiary
requirements proposed in the Second Further Notice of Proposed
Rulemaking FCC 23-64 (88 FR 17495, March 23, 2023). In connection with
RHC Program supported services, we request comment on possible ways to
promote use of lower-cost backup services, and request comment on the
establishment of an RHC Program eligible services list similar in
concept to that in place for the E-Rate program. Regarding RHC Program
processes, we seek comment on whether to adopt performance metrics
applicable to the processing of RHC Program applications, and on
whether to eliminate the Universal Service Administrative Company's
(USAC) approval of evergreen contracts and the rule requiring the
submission of an annual report by entities that receive Healthcare
Connect Fund (HCF) Program support. The common thread in these
proposals is the intent to reduce burdens and costs on RHC Program
participants while protecting the limited resources of the Universal
Service Fund by preventing waste, fraud, and abuse. When commenting on
our proposals, or when offering alternatives to our proposals, we
encourage commenters to explain how their positions further those
goals.
A. Improving Support Calculations in the Telecom Program
1. Redefining Similar Services and Rural Area Comparability
Section 254(h)(1)(A) of the Communications Act of 1934 requires
carriers to provide services to eligible health care providers ``at
rates that are reasonably comparable to rates charged for similar
services in urban areas in that state,'' and provides that Telecom
Program support be based on the difference between that urban rate and
the rural rate, which is the rate ``for similar services provided to
other customers in comparable rural areas.'' In 2019, the Commission
defined ``similar services'' to include services with advertised speeds
30% above or below the speed of the requested service. It also directed
USAC, when determining similar services, to not limit the similar
service inquiry to solely telecommunications services but instead to
use a technology-agnostic approach that determines similarity from the
perspective of the end user. The Commission affirmed these standards in
2023. Also in 2023, by restoring the previous rural rate determination
rules after eliminating the Rates Database, the Commission in effect
reinstated the pre-2019 definition of ``comparable rural area'' to be
the immediate rural area in which the health care provider is located,
but sought comment on what constitutes ``comparable rural areas.'' We
now refresh the record by seeking additional comment on whether and how
we should redefine the scope of ``similar services'' and ``comparable
rural areas.''
We first ask whether the plus-or-minus 30% threshold for similar
services is still a reasonable interpretation of the Act, or should we
consider another approach to defining similar services? To the extent
we decide to eliminate or broaden the requirement that the speeds of
the comparable services must be within 30% of the speed of the
requested service, how should we adjust the price of the comparable
service to reflect any differences in speed? For example, if there were
a 100 Mbps service sold to a non-HCP commercial customer in a rural
area, and the provider wanted to justify the price of a 1 Gbps service
that it wants to sell to an HCP, how should the price of the 100 Mbps
service be adjusted to project the 1 Gbps price? One possible approach
would be to convert the price of the 100 Mbps service to a price per
Mbps and then multiply that price times the number of Mbps requested by
the HCP. We note, however, that prices generally do not
[[Page 55818]]
rise linearly with speed (i.e., the price per Mbps tends to decline as
speed increases). Given this, how should we adjust the per Mbps price
to reflect differences in bandwidth between the requested service and
the comparable service? Should adjustments also be made for other
differences in product characteristics, and if so, how might this be
accomplished?
If we eliminate the 30% speed restriction and allow providers to
adjust rates to account for differences in bandwidths, should we
require that a provider submit multiple comparable commercial rates and
then average the adjusted rates for the similar services in some way to
reduce variation? If so, do we risk introducing bias into the
calculation of the rural rate? For example, if providers include rates
that are increasingly dissimilar to the supported service (e.g.,
farther from the requesting HCP location), could this result in a less
accurate estimate of the price of the supported service absent
appropriate adjustments? In addition, if we allow the provider to
choose which commercial rates it wants to use for purposes of
calculating an adjusted rate for the supported service, this could lead
to selection bias (i.e., the provider might choose only those
commercial services that would yield the highest derived price for the
supported service). Would a possible solution to this bias problem be
to require a provider seeking RHC Program support to file data on all
``sufficiently similar'' commercial rates within a ``sufficiently close
proximity'' of the HCP for which the supported rate is being
calculated, and if so, how should we define these terms to collect the
appropriate universe of rates for similar services?
The former Rates Database demonstrated that, in addition to
bandwidth, there are other factors that affect the costs of providing a
broadband service to a location and the monthly recurring charges for
the service, and that if these factors are not accounted for,
inaccurate price projections may result. These factors may include the
location of the customer, the distance and terrain that the service
provider must cover to connect to the customer, the technology used,
the type and cost of middle mile transport, the contract length, the
service level agreement, the number of channel terminations, the
geographic pricing area, and the monthly spending commitment, among
other factors. Given all the factors that affect the costs of providing
a service and observed broadband prices, how should the Commission
determine which services and rates qualify as sufficiently similar?
The hierarchical approach to determining rural rates, which assigns
priority to Methods 1 and 2, represents a preference for the use of
commercial rates over the use of cost studies available under Method 3.
In recent years, however, there has been a significant decline in the
number of Telecom Program applications that have relied on Methods 1
and 2. For example, in Alaska, in funding year 2024, only 32 of 317
approved Telecom Program requests relied on Methods 1 or 2, while in
funding year 2025, only 34 of 340 approved Telecom Program requests in
Alaska relied on Methods 1 or 2. We seek comment on whether expanding
the 30% speed restriction may promote expanded use of Method 1 or 2.
Does the 30% restriction unduly limit the number of commercial rates
that could be used in determining rural rates, and therefore limit a
provider's ability to employ Methods 1 and 2? We also seek comment on
whether we should continue to employ a ``functional'' approach to
defining similar services, or should instead require that services be
technologically similar.
Turning to how to redefine ``comparable rural areas,'' does
``comparable'' necessarily mean rural areas in the same state or may
that geographic area encompass rural areas in adjoining states so long
as they have similar levels of rurality? Section 254(h)(1)(A) of the
Communications Act of 1934 requires the provision of telecommunications
service at rates that are ``reasonably comparable to rates charged for
similar services in urban areas in that State.'' Is it possible to read
this language to include rural areas in adjoining states? On a separate
point, is some form of rurality tiers, in which rates from more rural
areas of a state are prevented from being unfairly reduced by the
inclusion of rates for similar services in less rural areas, workable
despite the inaccuracies and inconsistencies observed during our
earlier attempt at such tiers? We encourage commenters to support their
positions with actual examples of how their preferred definitions of
similar services and comparable rural areas would work in practice.
2. Improving or Replacing Cost Studies
We next consider the possible improvement or replacement of cost
studies. Under our current rules, cost-based rates must be justified
under Method 3, including by submitting ``an itemization of the costs
of providing the requested service.'' In the Second Further Notice of
Proposed Rulemaking, the Commission sought comment on a proposal to
maintain Method 3 but with the requirement that service providers
seeking approval of a cost-based rate submit a cost study that
satisfies the same evidentiary requirements that the Commission adopted
as required for a waiver of the Rates Database. Parties submitting
comments in response to the Second Further Notice of Proposed
Rulemaking opposed that proposal, objecting to cost studies generally
as expensive and time-consuming for the service provider to prepare and
for the Commission to review, while also questioning their accuracy.
Commenters also opposed the proposed evidentiary requirements as
unnecessary and counterproductive. These parties maintained that the
proposed requirements are not needed to persuade service providers to
use simpler rural rate-determination methods because the existing
Method 3 process already imposes burdens and processing delays
significant enough to encourage use of alternatives. One commenter, GCI
Communication Corp. (GCI), also offered alternatives to cost studies
that it believes can be used in cases where rates cannot be determined
using other means.
While the Commission previously recognized the burdens associated
with cost studies, the comments filed in response to the Second Further
Notice of Proposed Rulemaking heighten our awareness of this issue, and
prompt us to revisit the efficacy and desirability of our existing cost
study approach under Method 3. The comments also inform us of the
potential benefits that could be realized from employing alternatives
to Method 3. We discuss the reduction of cost study burdens and
possible cost study alternatives below in turn, and encourage
stakeholders to comment on our proposals, and to offer proposals of
their own, that seek to improve the methodology of determining rural
rates.
a. Reducing Cost Study Burdens
As noted, the record in response to the Second Further Notice of
Proposed Rulemaking suggests that the cost study required under Method
3 is burdensome for service providers to prepare. These apparent
burdens notwithstanding, the record also reveals that cost studies,
initially intended to be a seldom-used ``safety valve,'' have become
instead an increasingly utilized method for determining rural rates.
For example, after the use of previously approved rural rates was
permitted under a waiver granted by the Commission following the repeal
of the Rates Database in 2023, participants in the Telecom Program
utilized previously approved rates nearly 500 times in funding years
2024 and 2025 to justify rural rates. Absent
[[Page 55819]]
the waiver, the Commission likely would have seen a large number of
cost studies submitted for approval. There is also a risk that service
providers may have chosen to not bid for services if they could not
easily justify rates. While various parties oppose the evidentiary
requirements proposed in the Second Further Notice of Proposed
Rulemaking and argue that cost studies in general are burdensome, the
dearth of Telecom Program approved rural rates that were based on
Methods 1 and 2 suggests that, if we eliminate the current waivers,
more providers may need to rely on Method 3 cost studies.
Given this, we seek comment on how we can reduce the possible
burdens associated with cost studies, while ensuring they remain
transparent and reliable. Section 254(h)(1)(A) of the Communications
Act of 1934 requires that rates must reflect the difference between the
urban and rural rate (i.e., the rate for similar service provided to
other customers in comparable rural areas in that state) but does not
specify the manner in which rates must be documented or specify a
general standard or framework for ensuring accurate rates. We believe
the statutory language requires the Commission to protect against
improper payments and, accordingly, the Commission has a responsibility
to ensure that rural rates are backed by trustworthy, accurate, and
well-documented data. We seek comment on these beliefs and on the
appropriate types and granularity of data needed to fulfill this
obligation. Commenters are encouraged to identify the specific burdens
and benefits of cost studies.
Evidentiary Requirements. In 2023, the Commission proposed that
service providers seeking approval of a cost-based rate satisfy the
same evidentiary requirements adopted by the Commission in 2019 for use
in connection with requests for waiver of use of the Rates Database.
This proposal, intended to increase transparency in how service
providers calculate cost-based rates, would require service providers
to include all financial and other information to verify the service
provider's assertions, including, at a minimum, the following
information:
Company-wide and rural health care service gross
investment, accumulated depreciation, deferred state and federal income
taxes, and net investment; capital costs by category expressed as
annual figures (e.g., depreciation expense, state and federal income
tax expense, return on net investment); operating expenses by category
(e.g., maintenance expense, administrative and other overhead expenses,
and tax expense other than income tax expense); the applicable state
and federal income tax rates; fixed charges (e.g., interest expense);
and any income tax adjustments;
An explanation and a set of detailed spreadsheets showing
the direct assignment of costs to the rural health care service and how
company-wide common costs are allocated among the company's services,
including the rural health care service, and the result of these direct
assignments and allocations as necessary to develop a rate for the
rural health care service;
The company-wide and rural health care service costs for
the most recent calendar year for which full-time actual, historical
cost data are available;
Projections of the company-wide and rural health care
service costs for the funding year in question and an explanation of
these projections;
Actual monthly demand data for the rural health care
service for the most recent three calendar years (if applicable);
Projections of the monthly demand for the rural health
care service for the funding year in question, and the data and details
on the methodology used to make that projection;
The annual revenue requirement (capital costs and
operating expenses expressed as an annual number plus a return on net
investment) and the rate for the funded service (annual revenue
requirement divided by annual demand divided by 12 equals the monthly
rate for the service), assuming one rate element for the service, based
on the projected rural health care service costs and demands;
Audited financial statements and notes to the financial
statements for the most recent three fiscal years, if available, and
otherwise unaudited financial statements for those years, specifically,
the cash flow statement, income statement, and balance sheets. Such
statements shall include information regarding costs and revenues
associated with, or used as a starting point to develop, the rural
health care service rate; and
Density characteristics of the rural area or other
relevant geographical areas including square miles, road miles,
mountains, bodies of water, lack of roads, remoteness, challenges and
costs associated with transporting fuel, satellite and backhaul
availability, extreme weather conditions, challenging topography, short
construction season, or any other characteristics that contribute to
the high cost of servicing the health care providers.
Commenters who opposed this proposal as unnecessary, burdensome,
and unlikely to encourage use of Methods 1 and 2 did not offer possible
alternatives or improvements to the proposed requirements. Here, we
seek comment on which of the proposed evidentiary requirements are
necessary to preserve the transparency and reliability of cost studies
and which can be eliminated without endangering the integrity of the
funding process. Would it reduce the burden on applicants and
facilitate Commission review of cost studies if the Commission were to
adopt a standardized approach or template for cost studies? If so,
please provide examples of such a standardized approach or cost study.
b. Cost Study Alternatives
We next turn to three cost study alternatives based on GCI's
suggestions offered in response to the Second Further Notice of
Proposed Rulemaking. We seek comment on these proposals--involving
wholesale rates, previously approved cost models or rates, and rate
projections--as well as on other possible approaches. We also seek
comment on whether we should adopt only one alternative or provide
program participants with a suite of options to choose from to justify
rural rates.
Wholesale Rates. The first cost study alternative would allow the
wholesale rates that a service provider actually charges other service
providers for the same or similar service to be submitted for approval
as a cost-based rate. This alternative is similar to Method 1 in that
it allows the submission of rates charged to other customers but is
differentiated by the documentation required to justify the rate. Under
this approach, a service provider would be required to submit an
invoice or contract showing the wholesale rate, rate of return, taxes,
and working capital to justify the costs of providing service.
We seek comment on this proposal. First, we seek comment on how we
should determine whether the wholesale service is sufficiently similar
to the services whose price is being justified. We also seek comment on
circumstances under which a wholesale rate charged by a service
provider to a third party could provide a cost-based justification for
the rate. In particular, we seek comment on whether we should view the
wholesale rate as cost based if the wholesale service is used to
support a service supported by the Universal Service Fund, such as with
E-Rate or the RHC Program. We also seek comment on whether we should
consider wholesale rates to be cost based if the wholesale provider has
market power with respect to the wholesale service. In such a case, how
[[Page 55820]]
should market power be defined? We also seek comment on whether we
should allow a provider to add additional costs to a wholesale rate
that it charges other carriers. For example, does it make sense to
allow a provider to add an additional rate of return to a wholesale
rate that it offers other carriers, since the provider would not have
offered the wholesale service at all if it were not making a profit on
the service? Finally, we seek comment on whether other safeguards would
be required to allow wholesale rates to be used to justify rural rates.
For example, should we disallow wholesale rates contracted with
affiliated companies? Would the contract need to be for a standalone
wholesale service so that the price associated with the service is not
affected by other services being purchased?
In addition, we seek comment on whether providers should be allowed
to add an additional rate of return to a wholesale rate offered to
other carriers and, if so, what an appropriate cap would be for the
claimed rate of return and how this rate of return could be verified.
Should the Commission rely on 9.75% as the cap used for high-cost rate-
of-return carriers, or should it vary by some other characteristics,
like service and location? Should the rural rate be adjusted downward
until the return on reported working capital is equal to the maximum
allowable return, and how should this be done? Finally, we seek comment
on how, if the wholesale service supports service to multiple
locations, the cost of that wholesale service can be allocated for the
purpose of setting a rural rate for service to a single location.
Previously Approved Cost Models or Rates. Our second proposed
alternative to cost studies involves the use of previously approved
cost models or rates. The Commission has twice waived Sec. 54.605(b)
of the Commission's rules to permit the use of previously approved
rates that would otherwise require approval of a cost-based
justification, specifically to cover funding years 2024 through 2026.
In the Order, we again waive our rule to permit the use of previously
approved rates for funding year 2027. We seek comment on a proposal
that would have the practical effect of making these rule waivers
permanent.
We first seek comment on how the use of previously approved rates
would work on a permanent basis. Should the Commission accept
previously approved rates that were based on a cost model as a rate
ceiling that a provider can use for the same service offered to a
location or a location within close geographic proximity? Should there
be a limit to how recent a rate must have been approved in order to use
it as justification for a new rate? Should there be a time limit for
how long a provider can rely on a previously approved rate before being
required to have the rate reapproved using Method 1, 2, or 3? If so, we
seek comment on the appropriate timelines for each of these parameters.
Are there trends in the industry that the Commission should account for
in these timeframe requirements? Given ongoing network deployments, the
Commission believes rates will decrease over time and available
bandwidth capacity will increase. Therefore, older rates may
overcompensate providers relative to current market rates. We seek
comment on this and how the Commission should factor these trends into
any rules permitting the use of previously approved rates.
Additionally, should the use of previously approved rates be limited to
rates approved under Method 1, Method 2, or Method 3?
The waivers adopted in the past allowed for the use of rates
approved within the past three funding years. Should there continue to
be limits on how long a previously approved rate can be relied on by a
provider? For example, if we permit using rates approved in the last
three years as we have before, and a provider uses a rate approved two
years ago, should it only be allowed to do that once? If not, the
provider could continually use the same rate indefinitely, as it would
become a newly approved rate every three years. Can rates approved
under this approach be used as justification for rates proposed in
future years under this or other proposed approaches?
Rate Projections. The final proposed alternative involves rate
projections. Under this approach, service providers would be allowed to
use a rational rate projection to justify the rural rate where the same
service is justified at a lower bandwidth or range of bandwidths under
Methods 1 or 2. The projection approach would allow service providers
to develop a rate table for HCPs to understand specific tiers of
service. We seek comment on whether the Commission should permit
providers to use previously justified rural rates for a service to
extrapolate a rural rate for the same service at a different bandwidth
than the observed rates. In addition, consistent with our similar
services and rural area comparability inquiry above, we seek comment on
what the guidelines should be for characterizing a service as similar
and a geographic rural area as comparable, and therefore appropriate to
use for projecting a new rate.
We next seek comment on whether projections be allowed for
bandwidth amounts that are greater than the bandwidths observed in the
supporting rates (i.e., extrapolation), or limited to projections for
bandwidths that are between the bandwidths observed in the supporting
rates (i.e., interpolation)? We note that, in general, interpolation
likely provides more accurate estimates than extrapolation because it
estimates values within the range of the underlying data and therefore
is constrained by the surrounding data points. If projections are only
allowed for bandwidths within the range of observed bandwidths in the
supporting rates, should the range of data be required to satisfy
certain criteria? For example, would it be problematic if a provider
submitted rate data for MPLS circuits with bandwidths of 1 Mbps and 1
Gbps and used this data to project rates for a 500 Mbps MPLS circuit?
We also seek comment on what parameters should be required of the
supporting rates. Should we require that a certain minimum number of
rates for similar services used for the projection? If so, what should
that number be? In cases of interpolation, should a certain percentage
of the rates be required to be below the bandwidth of the rate being
projected and a certain percentage above? If extrapolations to higher
bandwidth services are allowed, should the criteria for those
supporting rates be more stringent than the criteria required for
interpolation? We recognize that the cost of a service typically does
not increase linearly as the bandwidth increases. In fact, observed
costs are generally highly non-linear, with the prices of 1 Gbps
circuits being far below the amount that would be predicted from
multiplying a 100 Mbps circuit by 10. Given this empirical regularity
in broadband pricing data, should there be limitations put in place to
guard against linear pricing, especially in cases of extrapolation? If
so, what should those guardrails look like?
We seek comment on limiting projections to interpolation or
extrapolation of rates based on rates that were approved within the
past two years under Methods 1 or 2 for services that are appropriately
similar in both rurality and product characteristics, and on an
appropriate number of rates for similar services (consistent with how
we ultimately define ``similar'') to support a newly projected rate.
Finally, we seek comment on the appropriate format to collect the data,
methodology, and justification in order to limit burden to providers
and Commission staff.
[[Page 55821]]
Should the Commission require the submission of any specific supporting
documents, like signed contracts or public-facing information, during
the review process?
Other Alternatives. Using wholesale rates, previously approved
rates, and rate projections are not the only possible alternatives to
cost studies. We seek comment on other approaches. For example, if
tariffed or publicly available rates are not available or cannot be
used in a particular case, should we consider rates from another area,
time period, or type of service or service level standard? If so, what
justification would be required to show such rates are representative?
Should providers be required to certify under penalty of debarment that
they provided all known tariffed or publicly available rates from the
other area or time period? Should the Commission also request rates for
different services and service standards in a given area? Could the
Commission use other existing data (e.g., from other Universal Service
Fund programs like the HCF Program or E-Rate program) to model the
costs of service to determine potential reasonable ceilings that could
be used as an alternative? Commenters offering alternative approaches
should demonstrate how and why their proposed approaches will reduce
administrative burdens while simultaneously setting rural rates that
are accurate measures of the true cost of telecommunications services.
Finally, we ask whether the Commission should offer a choice of cost
study alternatives rather than only one approach. Does offering service
providers the discretion to choose a cost study alternative
overcomplicate the rate-approval process? Is there a risk that, with a
suite of options to choose from, program participants will face a new
level of burden resulting from having to make market-by-market
determinations of the best option to take?
B. Making Effective Use of RHC Program Supported Services
1. Promoting Lower-Cost Secondary Services
We next seek comment on measures to promote health care providers'
use of lower-cost options for backup (i.e., secondary) services. Backup
services can be an essential component of a health care provider's risk
management plan by providing continuity of patient care in the event of
a communications system failure or cyber threat. The Commission has
previously concluded, however, that the cost of bandwidth for a backup
service ``must reasonably reflect its use as a secondary service, and
it must be the most cost-effective option available.'' With this
standard in mind, we seek comment on possible ways to lower program
costs associated with secondary services.
The RHC Program rules currently do not distinguish primary services
from secondary services. This lack of a distinction may lead to cost
inefficiencies, such as a health care provider that uses more expensive
C-band satellite services for both primary and secondary services where
a less costly low earth orbit satellite service could be used instead
for secondary services. How commonplace is this scenario, where a
lower-cost technology can replace a more expensive technology to meet
the health care provider's needs for secondary service? Alternatively,
how commonplace is the scenario where health care providers choose a
higher service level standard when a lower-cost alternative is
available? In the HCF Program, price must be a primary factor that an
applicant considers when choosing the required most cost-effective
service offering. However, when facing a choice between service options
at varying costs, a health care provider may reasonably reject lower-
cost options due to concerns regarding the lower-cost technology's
reliability or other functional shortcomings. How often do health care
providers face this choice, and what metric or standard is used to
weigh the competing interests of functionality and cost effectiveness?
We ask that commenters support their responses with actual examples
identifying the specific technology(ies) of where they opted for
higher-cost options when lower-cost alternatives were available and
explanations as to why the higher-cost service was selected.
We seek comment on whether we should modify the RHC Program rules
to distinguish between primary and secondary services. The Commission
has historically been technology-agnostic in regard to the services
eligible for funding in the RHC Program. For secondary services, should
we limit the technologies eligible for support? Should we limit the
cost or the performance characteristics of the secondary service to no
greater than that of the primary service? We seek comment on codifying
the existing guidance that a secondary service ``must reasonably
reflect its use as a secondary service, and it must be the most cost-
effective option available'' into our program rules for clarity. Should
cost be a primary factor for secondary services or should we take into
account other factors? If so, what should those factors be? Has a
primary factor requirement been problematic in the HCF Program? Due to
the importance of connectivity for health care providers, should the
primary focus of both primary and secondary services be ensuring
reliable connectivity regardless of price and technology? Are there
other considerations we should take into account when examining
potential limitations on technologies for secondary services? The
Commission currently prioritizes RHC Program support based on eight
tiers ranked by degree of rurality and greatest medical need. Should we
consider delineating primary and secondary services and prioritizing
primary over secondary services when reviewing funding requests?
What level of capacity, latency, and security is necessary to
support healthcare providers and networks? Are there any special
considerations around network resiliency, latency, capacity, etc. for
health care when it comes to support for secondary services? How is the
current competitive bidding process impacted if an applicant is seeking
bids for secondary services? How does a service provider responding to
a request for proposal qualify that its services meet the applicant's
needs in terms of network resiliency, safety, or otherwise?
2. Establishing an RHC Program Eligible Services List
We next propose to adopt an eligible services list for the RHC
Program, modeled in part after the E-Rate program's eligible services
list. An eligible services list specifies the services that will be
supported for eligible program participants. The Commission delegated
responsibility to the Wireline Competition Bureau to annually seek
public comment on an eligible services list for the E-Rate program,
which is prepared and released prior to the opening of each funding
year's application filing window. We seek comment on whether the
adoption of an analogous eligible services list for the RHC Program
would promote clarity and consistency regarding the telecommunications
and broadband services and equipment eligible through the program.
While the RHC Program lacks a formal eligible services list, lists
of common products and services that qualify for support have been
available through the USAC website for about five years. However, the
adoption of a formal eligible services list would better align the RHC
Program with other universal service programs. Not only has the E-Rate
program released eligible services lists since 1998, such lists have
been
[[Page 55822]]
used in connection with three recent temporary universal service
programs: the COVID-19 Telehealth Program, the Connected Care Pilot
Program, and the E-Rate Cybersecurity Pilot Program. In addition,
adopting an eligible services list could make RHC Program rules more
transparent, easier to administer, and more comprehensible,
particularly for new entrants to the program.
We invite comment on our proposal to create an RHC Program eligible
services list. Have conditions changed since the Commission opted to
not adopt an eligible services list when establishing the HCF Program
in 2012 that now support adopting such a list for the RHC Program? Do
stakeholders have examples of specific situations where the
availability of an eligible services list would have been useful? Will
the creation of an eligible services list help applicants (including
both providers and health care providers) in applying for support? For
instance, are stakeholders experiencing problems with specific
eligibility where a service or product appears eligible, but a funding
application is denied after USAC review? If so, we invite comment on
whether this would be better resolved with an eligible services list or
an alternative change to our rules. Would an eligible services list
increase transparency and make program administration simpler both for
participants and the Commission? We also seek comment on how an
eligible services list would work in practice. How frequently would the
list need to be updated? We propose that revisions to the eligible
services list be conducted on an as-needed basis with authority
delegated to the Wireline Competition Bureau to seek comment on changes
and on whether separate lists are needed for the Telecom and HCF
Programs. Are there other aspects of the E-Rate program eligible
services list process that should be modified for the RHC Program and,
if so, how and for what reason? Alternatively, could the advantages of
a more comprehensive eligible services list be achieved through
modifications to existing USAC or Commission websites, without the
adoption of rules?
Relatedly, the Ad Hoc Broadband for Rural Health Group (Ad Hoc
Group) suggests that the Wireline Competition Bureau seek comment and
publish guidance and clarifications on the list of entities eligible to
participate in the RHC Program. Consistent with the Ad Hoc Group's
desire for clarification and its cite to a prior Wireline Competition
Bureau order as an example of helpful clarification, we direct the
Wireline Competition Bureau to look for opportunities to further
clarify the scope of eligible entities in the course of acting on RHC
Program issues in the future. We also seek comment on which of the
seven types of eligible health care providers require specific
clarification and whether the Commission should adopt more formal
definitions of each entity type, and, if so, recommendations for how to
define.
C. Evaluating and Improving Program Processes
1. Applying Performance Metrics
We next ask whether we should adopt performance metrics to support
the goal of making RHC Program application processing faster and more
effective. The Commission adopted metrics for the E-Rate program in
2014 by directing USAC to aim to issue funding commitments or denials
for all ``workable'' funding requests by September 1 of each funding
year. The Commission defined ``workable'' to mean a funding request
that is timely filed and complete with all necessary information, and
filed by an applicant (or its service provider and consultants) not
subject to investigation, audit, or other similar reasons to delay a
funding decision. Should we adopt a similar performance metric for the
RHC Program? Does the RHC Program's recent history warrant this or
other processing targets? A September 1 deadline would provide USAC
with approximately five months after the application filing deadline to
review RHC Program funding requests. We note that the September 1
deadline for the E-Rate program was established with the intent of
providing applicants ``certainty . . . by the beginning of the school
year.'' Does the inapplicability of a school year to the RHC Program
mean that another deadline would be more or equally appropriate? As
always, we seek to balance program integrity with efficiency and
predictability. Could an expedited processing timeline increase the
risk of RHC Program waste, fraud, and abuse? If more (or less)
processing time than five months is preferred, why? The E-Rate metrics
recognize that even ``workable'' funding requests may be time-consuming
for USAC to process due to the need for additional information from the
applicant. We seek comment on whether there are RHC Program-specific
exceptions that should be considered in determining what is a
``workable'' funding request.
Are there alternative measures to establishing a September 1 target
(or any other specific deadline) that would more clearly define and
track USAC's administrative procedures during an application review? In
addition to considering performance metrics, data collected, and
deadlines, what other ways can the Commission streamline the
application process, clarify program rules, ensure effective and timely
communication between USAC and applicants, and promote efficient
program administration? Is there specific information that would be
particularly helpful to publish in the RHC Open Data datasets? Are
there other process controls that would keep the application process
moving forward?
2. Changing Evergreen Contract Approval Timing
We next seek comment on whether to eliminate the requirements in
Sec. 54.622(i)(3) of the Commission's rules for USAC to approve multi-
year contracts in the RHC program as ``evergreen'' before applicants
can avail themselves of the competitive bidding exemption for
``evergreen'' contracts. Evergreen contracts are one of the exemptions
to the general rule that applicants are required to undergo a
competitive bidding process to identify the most cost-effective service
in order to receive RHC Program support. After USAC designates a multi-
year contract as evergreen, an applicant with an evergreen contract
need not undertake competitive bidding for the life of the contract.
The Schools, Health & Libraries Broadband Coalition (SHLB), in response
to the Delete, Delete, Delete (FCC 25-219, March 12, 2025) initiative,
recommends that the requirements in Sec. 54.622(i)(3) of the
Commission's rules for USAC to approve multi-year contracts as
``evergreen'' be eliminated as ``unnecessary,'' maintaining that
``there is no need for applicants to submit and wait for approval from
USAC for their multi-year contracts.'' SHLB recommends that the RHC
Program follow the approach used in the E-Rate program, where USAC
approval of evergreen contracts is not required and ``applicants simply
have to seek competitive bids when the multi-year contract is
expiring.''
We seek comment on SHLB's recommendation to eliminate the
requirements in Sec. 54.622(i)(3) of the Commission's rules for USAC
to approve multi-year contracts as ``evergreen'' before applicants can
avail themselves of the competitive bidding exemption. As SHLB points
out, the E-Rate program does not require evergreen contract approval.
However, E-Rate competitive bidding violations can be discovered after
a number of years, resulting in a larger recovery. Are the minor
burdens of the evergreen contract
[[Page 55823]]
review outweighed by the benefits of ensuring that the contract is
approved for its duration? Alternatively, are there ways the approval
process be shortened so that it still delivers benefits while
minimizing burdens? Are health care providers in the position to assume
the risk of a potential future finding of a violation if they rely on a
yet-to-be-approved evergreen contract?
3. Eliminating HCF Annual Report Requirement
We next propose to eliminate a reporting requirement that our
current rules impose on HCF Program applicants. When the HCF Program
was established in 2012, the Commission adopted a rule, now contained
in Sec. 54.618 of the Commission's rules, that requires each HCF
Program applicant to file an annual report with USAC on or before
September 30 for the preceding funding year. The Commission adopted
this reporting requirement to provide ``information necessary to ensure
the Commission can assess progress towards the performance goals and
measures'' adopted in the HCF Order, FCC 12-150 (78 FR 13936, March 1,
2013). The Ad Hoc Broadband for Rural Health Group (Ad Hoc Group), in
response to the Delete, Delete, Delete initiative, requests that Sec.
54.618 of the Commission's rules be eliminated. The Ad Hoc Group
maintains that the data gathered by the annual reports ``is no longer a
meaningful metric for measuring HCF performance goals'' because of how
much telehealth services have grown and changed since 2012.
We tentatively agree with the Ad Hoc Group, and propose deleting
the HCF annual report requirement. The HCF Program has established
itself as the predominant funding mechanism of the RHC Program. In
funding year 2024, the most recent funding year for which complete data
is available, the HCF Program accounted for 56.8% of the RHC Program
funding commitments in terms of dollars. We tentatively conclude that
the information gathered by the annual report requirement is no longer
needed to measure the progress of HCF Program goals now that the
program is so firmly established. The report instead serves as a hurdle
that HCF Program applicants must clear in order to receive universal
service support.
We request comment on our proposal to eliminate the HCF Program
annual report requirement and our tentative conclusion that collection
of this information is no longer necessary. Is the data collected in
the annual reports of continuing value? Does the burden associated with
complying with the annual reporting requirement outweigh any benefit
for program administration? If the annual reporting requirement is to
be retained, should the reports require different or additional
information? Should the frequency and form of the retained reports
remain as they are or revised to minimize the administrative burdens
placed on reporting entities? We encourage commenting parties that
favor continuation of the annual reports to explain how the value of
the information contained in the reports outweighs the burdens
associated with compiling and submitting the reports.
II. Procedural Matters
A. Paperwork Reduction Act
Paperwork Reduction Act. This FNPRM may contain proposed new or
modified information collections. The Commission, as part of its
continuing effort to reduce paperwork burdens, invites the general
public and the Office of Management and Budget (OMB) to comment on any
information collections contained in this document, as required by the
Paperwork Reduction Act of 1995, 44 U.S.C. 3501-3521. In addition,
pursuant to the Small Business Paperwork Relief Act of 2002, 44 U.S.C.
3506(c)(4), we seek specific comment on how we might further reduce the
information collection burden for small business concerns with fewer
than 25 employees.
B. Regulatory Flexibility Act
Regulatory Flexibility Act. The Regulatory Flexibility Act of 1980,
as amended (RFA), requires that an agency prepare a regulatory
flexibility analysis for notice-and-comment rulemaking proceedings,
unless the agency certifies that ``the rule will not, if promulgated,
have a significant economic impact on a substantial number of small
entities.'' Accordingly, the Commission has prepared an Initial
Regulatory Flexibility Analysis (IRFA) concerning potential rule and
policy changes contained in the FNPRM. The Commission invites the
general public, in particular small businesses, to comment on the IRFA.
Comments must be filed by the deadlines for comments on the FNPRM
indicated in the DATES section of this document and must have a
separate and distinct heading designating them as responses to the
IRFA.
Ex Parte Rules--Permit-But-Disclose. This proceeding shall be
treated as a ``permit-but-disclose'' proceeding in accordance with the
Commission's ex parte rules. Persons making ex parte presentations must
file a copy of any written presentation or a memorandum summarizing any
oral presentation within two business days after the presentation
(unless a different deadline applicable to the Sunshine period
applies). Persons making oral ex parte presentations are reminded that
memoranda summarizing the presentation must (1) list all persons
attending or otherwise participating in the meeting at which the ex
parte presentation was made, and (2) summarize all data presented and
arguments made during the presentation. If the presentation consisted
in whole or in part of the presentation of data or arguments already
reflected in the presenter's written comments, memoranda or other
filings in the proceeding, the presenter may provide citations to such
data or arguments in his or her prior comments, memoranda, or other
filings (specifying the relevant page and/or paragraph numbers where
such data or arguments can be found) in lieu of summarizing them in the
memorandum. Documents shown or given to Commission staff during ex
parte meetings are deemed to be written ex parte presentations and must
be filed consistent with Sec. 1.1206(b) of the Commission's rules. In
proceedings governed by the Commission's rule Sec. 1.49(f) or for
which the Commission has made available a method of electronic filing,
written ex parte presentations and memoranda summarizing oral ex parte
presentations, and all attachments thereto, must be filed through the
electronic comment filing system available for that proceeding, and
must be filed in their native format (e.g., .doc, .xml, .ppt,
searchable .pdf). Participants in this proceeding should familiarize
themselves with the Commission's ex parte rules.
Providing Accountability Through Transparency Act. Consistent with
the Providing Accountability Through Transparency Act, Public Law 118-
9, a summary of the FNPRM will be available on https://www.fcc.gov/proposed-rulemakings.
C. Initial Regulatory Flexibility Analysis
As required by the RFA, the Commission has prepared this IRFA of
the possible significant economic impact on a substantial number of
small entities by the policies and rules proposed in the FNPRM. Written
public comments are requested on this IRFA. Comments must be identified
as responses to the IRFA and must be filed by the deadlines for
comments indicated in the DATES section of this document. In addition,
the FNPRM and
[[Page 55824]]
IRFA (or summaries thereof) will be published in the Federal Register.
As required by the Regulatory Flexibility Act of 1980, as amended
(RFA), the Federal Communications Commission (Commission) has prepared
this Initial Regulatory Flexibility Analysis (IRFA) of the policies and
rules proposed in the FNPRM assessing the possible significant economic
impact on a substantial number of small entities. The Commission
requests written public comments on this IRFA. Comments must be
identified as responses to the IRFA and must be filed by the deadlines
for comments specified in the DATES section of this document. In
addition, the FNPRM and IRFA (or summaries thereof) will be published
in the Federal Register.
1. Need for, and Objectives of, the Proposed Rules
The Commission is required by section 254 of the Communications Act
of 1934, as amended, to promulgate rules to implement the universal
service provisions of section 254. On May 8, 1997, the Commission
adopted rules to reform its system of universal service support
mechanisms so that universal service is preserved and advanced as
markets move toward competition. The Rural Health Care (RHC) Program
consists of two component programs: (1) the Telecommunications
(Telecom) Program, and (2) the Healthcare Connect Fund (HCF) Program.
The Telecom Program, established in 1997, subsidizes the difference
between the rates for eligible telecommunications services in the
health care provider's rural area and rates for comparable services
available in urban areas within that state. The HCF Program, created in
2012, promotes the use of broadband services and facilitates the
formation of health care provider consortia that include both rural and
urban health care providers by providing a flat 65% discount on an
array of advanced telecommunications and information services.
The FNPRM proposes several improvements to reduce administrative
burdens for RHC Program participants, as well as appropriate
administrative responses to increased program demand. We seek comment
on the scope of the similar service and rate comparability requirements
in section 254(h)(1)(A) of the Communications Act of 1934; possible
reforms to our existing cost study method of determining rural
telecommunications rates; possible methods of promoting the use of
lower-cost back-up and redundancy technologies; the establishment of an
eligible services list for the RHC Program; whether to increase the RHC
Program funding cap; and whether we should change how the RHC Program
prioritizes support in the event that demand exceeds the program
funding cap. We also request comment on whether to adopt USAC
performance metrics to expedite the processing of RHC Program funding
requests. Finally, we respond to two suggestions from stakeholders
offered in response to our Delete, Delete, Delete initiative by seeking
comment on the elimination of the evergreen contract competitive
bidding exemption and proposing to eliminate an annual program report
requirement
2. Legal Basis
The proposed action is authorized pursuant to sections 1, 4(j),
214, 254, and 303(r) of the Communications Act of 1934, as amended, 47
U.S.C. 151, 154(j), 254, and 303(r), and Sec. 1.3 of the Commission's
rules, 47 CFR 1.3.
3. Description and Estimate of the Number of Small Entities to Which
the Proposed Rules Will Apply
The RFA directs agencies to provide a description of and, where
feasible, an estimate of the number of small entities that may be
affected by the proposed rules, if adopted. The RFA generally defines
the term ``small entity'' as having the same meaning as the terms
``small business,'' ``small organization,'' and ``small governmental
jurisdiction.'' In addition, the term ``small business'' has the same
meaning as the term ``small business concern'' under the Small Business
Act. A ``small business concern'' is one which: (1) is independently
owned and operated; (2) is not dominant in its field of operation; and
(3) satisfies any additional criteria established by the SBA. The SBA
establishes small business size standards that agencies are required to
use when promulgating regulations relating to small businesses;
agencies may establish alternative size standards for use in such
programs, but must consult and obtain approval from SBA before doing
so.
Our actions, over time, may affect small entities that are not
easily categorized at present. We therefore describe three broad groups
of small entities that could be directly affected by our actions. In
general, a small business is an independent business having fewer than
500 employees. These types of small businesses represent 99.9% of all
businesses in the United States, which translates to 34.75 million
businesses. Next, ``small organizations'' are not-for-profit
enterprises that are independently owned and operated and not dominant
in their field. While we do not have data regarding the number of non-
profits that meet that criteria, over 99 percent of nonprofits have
fewer than 500 employees. Finally, ``small governmental jurisdictions''
are defined as cities, counties, towns, townships, villages, school
districts, or special districts with populations of less than fifty
thousand. Based on the 2022 U.S. Census of Governments data, we
estimate that at least 48,724 out of 90,835 local government
jurisdictions have a population of less than 50,000.
The rules proposed in the FNPRM will apply to small entities in the
industries identified in the chart below by their six-digit North
American Industry Classification System (NAICS) codes and corresponding
SBA size standard. Where available, we also provide additional
information regarding the number of potentially affected entities in
the industries identified in Table 1 (2022 U.S. Census Bureau Data by
NAICS Code) and Table 2 ((Telecommunications Service Provider Data).
4. Description of Economic Impact and Projected Reporting,
Recordkeeping, and Other Compliance Requirements for Small Entities
The RFA directs agencies to describe the economic impact of
proposed rules on small entities, as well as projected reporting,
recordkeeping and other compliance requirements, including an estimate
of the classes of small entities which will be subject to the
requirements and the type of professional skills necessary for
preparation of the report or record.
In general, the proposals in the FNPRM should reduce administrative
burdens for all program participants, including small entities, and
have minimal impact on the hiring of professionals for compliance
purposes for current participants who should be familiar with the
program. We seek comment on whether the cost study approach under
Method 3 is burdensome for providers to prepare, and whether and how to
reduce the requirements associated with cost studies. We also seek
comment on how to define the scope of ``comparable rural areas'' and
``similar services,'' and whether providers should be able to choose
from alternative options to justify rural rates. The FNPRM also seeks
comment on ways to lower costs using secondary services. We also
propose to adopt an eligible services list to better align with other
universal service programs. Finally, we seek comment on whether to
apply performance metrics for the RHC program and eliminate HCF annual
[[Page 55825]]
reporting requirements, as well as the evergreen contract approval
requirement. We do not expect the proposals to affect the overall size
of the RHC or the type of health care provider that participates.
5. Discussion of Significant Alternatives Considered That Minimize the
Significant Economic Impact on Small Entities
The RFA directs agencies to provide a description of any
significant alternatives to the proposed rules that would accomplish
the stated objectives of applicable statutes, and minimize any
significant economic impact on small entities. The discussion is
required to include alternatives such as: ``(1) the establishment of
differing compliance or reporting requirements or timetables that take
into account the resources available to small entities; (2) the
clarification, consolidation, or simplification of compliance and
reporting requirements under the rule for such small entities; (3) the
use of performance rather than design standards; and (4) an exemption
from coverage of the rule, or any part thereof, for such small
entities.''
The FNPRM proposes or seeks comment on several alternatives that
may reduce the economic impact on program participants, including small
entities. For example, we seek comment on alternatives to cost studies
proposed by commenters that may streamline cost studies and reduce
evidentiary requirements that some found to be burdensome. These
include using rate projections and associated methodologies, rates
previously approved for rural areas, or wholesale rates that service
providers charge other providers. The Commission welcomes submission of
any comments with constructive proposals that would minimize the
compliance burden or economic impact for small entities.
6. Federal Rules That May Duplicate, Overlap, or Conflict With the
Proposed Rules
None.
III. Ordering Clauses
Accordingly, it is ordered, pursuant to the authority contained in
sections 1, 4(j), 214, 254, and 303(r) of the Communications Act of
1934, as amended, 47 U.S.C. 151, 154(j), 214, 254, and 303(r), and
pursuant to Sec. 1.3 of the Commission's rules, 47 CFR 1.3, that this
FNPRM is adopted.
It is further ordered that pursuant to the authority in sections 1-
4 and 254 of the Communications Act of 1934, as amended, 47 U.S.C. 151-
154 and 254, and pursuant to Sec. 1.3 of the Commission's rules, 47
CFR 1.3, that Sec. 54.605(b) of the Commission's rules as amended
herein, 47 CFR 54.605(b), is waived to the extent provided herein.
List of Subjects in 47 CFR Part 54
Health facilities, internet, Reporting and recordkeeping
requirements, Telecommunications.
Federal Communications Commission.
Marlene Dortch,
Secretary.
Proposed Rules
For the reasons discussed in this document, the Federal
Communications Commission proposes to amend 47 CFR part 54 as follows:
PART 54--UNIVERSAL SERVICE
0
1. The authority citation for part 54 continues to read as follows:
Authority: 47 U.S.C. 151, 154(i), 155, 201, 205, 214, 219, 220,
229, 254, 303(r), 403, 1004, 1302, 1601-1609, and 1752, unless
otherwise noted.
0
2. Amend Sec. 54.603 by revising paragraph (b) to read as follows:
Sec. 54.603 Consortia, telecommunications services, and existing
contracts.
* * * * *
(b) Telecommunications services. Any telecommunications service
listed in the eligible services list as provided in Sec. 54.634 and
that is the subject of a properly completed bona fide request by a
rural health provider shall be eligible for universal service support.
Upon submitting a bona fide request to a telecommunications carrier,
each eligible health care provider is entitled to receive the most
cost-effective, commercially available telecommunications service, and
a telecommunications service carrier that is eligible for support under
the Telecommunications Program shall provide such service at the urban
rate, as defined in Sec. 54.604. Services that provide back-up,
redundant, or fail-over services are eligible for support, but the cost
and bandwidth of the service must reasonably reflect its use as a
secondary service and must be the most cost-effective option available.
* * * * *
0
3. Amend Sec. 54.612 by revising paragraph (a) to read as follows:
Sec. 54.612 Eligible services.
(a) Eligible services. Subject to the provisions of Sec. Sec.
54.600 through 54.602 and 54.607 through 54.634, eligible health care
providers may request support under the Healthcare Connect Fund Program
for advanced telecommunications or information service that enables
health care providers to post their own data, interact with stored
data, generate new data, or communicate, by providing connectivity over
private dedicated networks or the public internet for the provision of
health information technology. The services eligible for support shall
be contained in the eligible services list as provided in Sec. 54.634.
Services that provide back-up, redundant, or fail-over services are
eligible for support, but the cost and bandwidth of the service must
reasonably reflect its use as a secondary service and must be the most
cost-effective option available.
* * * * *
0
4. Sec. 54.618 [Remove and Reserve]
Reserve Sec. 54.618.
0
5. Add Sec. 54.634 to read as follows:
Sec. 54.634 Eligible Services List.
(a) Eligible services list. The Wireline Competition Bureau shall
issue a Public Notice seeking comment on a list of all supported
services eligible for Telecommunications Program and Healthcare Connect
Fund Program support. The Wireline Competition Bureau shall publish the
final list of services eligible for support at least 60 days prior to
the opening of the application filing window for the following funding
year. The eligible services list shall be subject to revision in
accordance with paragraph (b) of this section.
(b) Eligible services list revision. As needed to account for
changes to Commission rules applicable to subsequent funding years,
technology advances, and other circumstances that cause or will cause
the existing eligible services list to become outdated or incomplete,
the Wireline Competition Bureau shall issue a Public Notice seeking
comment on a revised eligible services list. The final revised list of
services eligible for support will be released at least 60 days prior
to the opening of the application filing window for the following
funding year.
[FR Doc. 2026-17767 Filed 8-28-26; 8:45 am]
BILLING CODE 6712-01-P