December 29, 2015

FCC Seeks Comment on Major Reforms to the Rural Health Care Program

Digital Health Download

Stakeholders have until January 14, 2016, to offer comments on a series of reforms to the Rural Health Care (RHC) program proposed in a Petition for Rulemaking filed with the Federal Communications Commission (FCC or Commission) in early December by a group of rural healthcare providers and the Schools, Health & Libraries Broadband Coalition. The petitioners claim their proposals will ameliorate health and technology-access disparities between rural and non-rural Americans "by supporting universal deployment of advanced telecommunications and information services to health care providers."

First, the petitioners argue requirements of the RHC's Healthcare Connect Fund (HCF) unduly discourage participation in the program. In particular, they claim the 35 percent of project costs required from recipients of support is too onerous and should be reduced to 15 percent. Especially since administrative costs are not eligible for support, the size of the match makes it difficult to form consortia of unaffiliated healthcare providers—even when they are the most efficient vehicle for improving rural healthcare delivery through connectivity.

Second, the petitioners seek greater funding for the RHC, asserting that the current $400 million annual funding cap was not based on an accurate record and "may grossly undercount" the number of potentially eligible healthcare providers. Pointing to a number of alleged flaws in the Commission's methodology for setting the funding cap, the petitioners ask the Commission to seek public comment about (1) the number of potentially eligible providers and (2) the availability of fiber-optic communications connections to potentially eligible providers as well.

Third, believing the RHC program may hit what the petitioners claim is its too-low annual spending ceiling before the FCC can raise it permanently, the petitioners urge the FCC to take various stopgap steps involving the use of undisbursed, uncommitted, or decommitted funds from prior years.

Fourth, the petitioners ask the FCC to review the Universal Service Administrative Company's (USAC's) administration of the RHC and take steps to improve the program's IT systems and other processes.

Fifth, the petitioners suggest expanding the classes of providers eligible for support for telecommunications infrastructure projects that improve the delivery of healthcare services to rural Americans, even if the providers are not, strictly speaking, "rural." Similarly, the petitioners seek clearer guidance about how USAC applies the eligibility criteria used in the RHC program.

Finally, the petitioners ask the Commission to relax certain prohibitions against funding networks for consortia of providers when not all of the consortium members are individually eligible for support. The petitioners argue that these restrictions promote inefficient network design, requiring that ineligible providers be bypassed, and lead to the artificial exclusion of ineligible providers from consortia when their membership otherwise would be beneficial. Instead, the petitioners say that consortia with a majority of eligible members should be able to receive HCF support, provided that the support is used only for eligible segments of the network.

The FCC's Public Notice provides until January 14 for stakeholders and interested parties to submit initial comments, with reply comments due January 29.


Tom McSorley
Tom McSorley
Senior Associate
Washington, DC
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