With Applications In, $50 Billion Rural Health Fund Faces Mounting Scrutiny

Critics say CMS rules steer money away from uncompensated care at the hospitals most at risk.

Overview

CMS says all 50 states submitted applications by the Nov. 5 deadline, with awards expected by year-end and funding distributed over five years.
Half of the money will be split equally among states with approved plans, while the rest will be awarded via a points-based system that includes rurality and policy criteria.
Program rules cap spending on unpaid patient care at 15% of any award, limit administrative costs to 10%, and bar using funds to supplement services already covered by insurers.
Senate Democrats, including Ron Wyden and Tina Smith, have asked the GAO to review fairness and implementation, and a Wyden aide says the watchdog has agreed to investigate.
State proposals emphasize workforce, telehealth and modernization, yet rural advocates warn those priorities and limited use rules may bypass small hospitals facing closures and broadband or transportation gaps.