The FCC is considering changes to the FCC Rural Health Care (RHC) program, which covers some of the costs of broadband service for rural health care providers. The commission today adopted a notice of proposed rulemaking (NPRM) seeking comment on a range of program changes.

“In this notice we tackle two key issues – what size should the program be going forward and how can it function more effectively,” said FCC Chairman Ajit Pai at today’s monthly FCC meeting where the NPRM was adopted.

Also at today’s meeting, the commission voted to increase the funding available for the RHC program on a one-time basis by carrying forward previously unused funds. That move aims to at least partially address a program budget shortfall for 2016 and expected budget shortfall for 2017.

Service providers that provide broadband to rural health care program participants also will have the option of voluntarily reducing their rates for qualifying fiscal year 2017 requests while keeping the support amount provided by the program consistent.

Possible FCC Rural Health Care Reforms
The potential FCC rural health care reforms under consideration include:

  • Increasing the program’s $400 million annual cap
  • Creating a prioritization mechanism in the event of demand exceeding the cap
  • Establishing a process for evaluating outlier funding requests
  • Reforming the calculation of urban and rural rates with the goal of improving fairness and transparency
  • Defining the “cost effectiveness” standard across the RHC program to encourage more efficient purchasing and fairer competitive bidding
  • Ensuring sufficient funding for rural and tribal healthcare providers while maintaining the participation of rural-urban provider consortia
  • Simplifying program participation
  • Enhancing program oversight

While the NPRM passed unanimously, different FCC commissioners emphasized different potential reforms in their comments at today’s meeting.

Commissioners Mignon Clyburn and Jessica Rosenworcel cited examples of life-saving or life-enhancing healthcare capabilities that are enabled by broadband such as remote radiology and a virtual reality system that enhances the training of healthcare providers.

Clyburn also argued that “counties with the worst access to physicians are the least connected.” She noted that this is just as true of an urban grandmother who must travel two hours by bus to see a doctor as it is for rural residents.

Commissioner Michael O’Rielly argued that under the existing program, some RHC funding recipients have purchased more capacity than they need and some have used funding to overbuild existing network facilities. O’Rielly said he will be reluctant to increase the budget for the RHC program without decreasing spending levels elsewhere.

He also argued that spending should not be determined solely by healthcare demand. The FCC’s job, he said, is to make service more affordable. He noted that while the RHC program may help reduce healthcare costs, those cost reductions do not offset the costs of the FCC program.

Commissioner Brendan Carr expressed concern that while the amount of funding awarded through the RHC program has increased, the number of participating health care providers has actually decreased.