FCC urged to expand $400M cap for Rural Health Care Program

Congress should explore other options to support surging use of telehealth in rural areas.


The Federal Communications Commission’s Universal Service Fund is playing a vital role in advancing access to high-quality care in rural America through telehealth programs and technologies. However, funding for the FCC’s Rural Health Care Program is not sufficient to meet growing needs for telemedicine services.

That’s the contention of Karen Rheuban, MD, director of the Center for Telehealth at the University of Virginia (UVA), which is also home to the Health Resources and Services Administration-funded Mid Atlantic Telehealth Resource Center, through which technical assistance is given to providers and systems across eight states and the District of Columbia.



The FCC’s Rural Health Care Program provides funding to eligible providers for telecommunications and broadband services. The goal of the program is to improve the quality of care available to patients in rural communities. Funding for the Rural Health Care Program is capped at $400 million annually.

“Telemedicine effectively mitigates the significant challenges of workforce shortages and geographic disparities in access to care, supported by secure broadband communications services—a critical underpinning of any telehealth program,” said Rheuban, during Tuesday’s Senate subcommittee hearing on the FCC’s Universal Service Fund and the deployment of broadband in rural America.

Also See: Groups ask FCC to bolster broadband-enabled healthcare

According to Rheuban, a pediatric cardiologist, the UVA telehealth program was established more than 20 years ago and has saved Virginians “millions of miles” of travel and improved patient outcomes.

“We rely on the FCC Rural Health Care Program for connectivity between facilities. Absent the program, our ability to provide these services would be severely constrained,” she told lawmakers.

However, Rheuban noted that “utilization has greatly increased, and recently the $400 million funding cap, established by the Commission in 1998, was exceeded.” In addition, she said the FCC has “recently reduced support by 7.5 percent, and this has created hardships for many states.”

As a result, Rheuban called on the FCC to expand the $400 million funding cap that it created nearly two decades ago. “If this is not feasible, we urge Congress and the FCC to explore additional federal options to support costly infrastructure build-outs for rural healthcare providers,” she added.

Further, Rheuban recommended expanding eligible healthcare providers under the Rural Health Care Program to include emergency medical service personnel and community paramedics, consistent with the public health and public safety provisions.

“We also recommend including wireless technologies as eligible under the Rural Health Care Program, especially as we strive to improve chronic disease management with remote monitoring tools,” she said.

“The Rural Health Care Program is foundational to a modernized healthcare delivery system and as such—along with other efforts—must be continued, expanded and further modernized to fulfill the promise of healthcare in the 21st Century,” Rheuban concluded.

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