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CMS Unveils First-Year Rural Health Grants for All 50 States Under $50 Billion Program

Awards follow an equal-plus-merit formula, with yearly re-scoring before disbursements begin in 2026.

Overview

  • CMS detailed a five-year, $50 billion Rural Health Transformation Program created under the Working Families Tax Cuts legislation, with $10 billion a year scheduled for 2026–2030.
  • First-year allocations average about $200 million per state and range from roughly $147 million to $281 million, including Texas at $281.3 million, Alaska at $272.2 million, and California at $233.6 million.
  • Half of each year’s funds are split evenly among states, while the remainder is weighted by rurality, existing rural infrastructure, and expert merit review of state proposals.
  • Implementation will be closely monitored through dedicated CMS project officers, annual progress reporting, a 2026 Rural Health Summit, and yearly re-scoring, with officials saying funds may be clawed back if commitments are not met.
  • The grants target workforce strengthening, facility and technology upgrades, and innovative care models such as telehealth, treat-in-place and behavioral health, with encouraged uses including AI documentation tools, cybersecurity, interoperability, drones for delivery, and robotic ultrasound pilots; a reported 15% cap limits direct provider payment.