What is the Rural Health Transformation Program?

The Rural Health Transformation Program (RHTP) is a $50 billion federal program, created by Section 71401 of Public Law 119-21 (the One Big Beautiful Bill Act), that CMS distributes to states over five fiscal years, FY2026 through FY2030, at $10 billion a year.

What do RHTP grant recipients have to track and report?

RHTP states must file annual progress reports with their continuation applications, Federal Financial Reports, FFATA subaward reports and audit reports, and they must show progress on the metrics and commitments in their approved plans.

How do states pass RHTP funds to rural hospitals and clinics?

States hold the RHTP cooperative agreements with CMS and pass money to rural hospitals, clinics and other partners through state funding notices (competitive subgrants), subrecipient agreements, contracts and interagency agreements, under state procurement rules.

What happens if an RHTP subrecipient falls out of compliance?

Under the CMS funding notice, a state has 90 days to remedy noncompliance after CMS notifies it; if it does not, CMS may withhold future payments and recover past payments, and the statute sends recovered money to the U.S. Treasury rather than back to the state.

What is a mock grant review and why do one before an RHTP audit?

A mock grant review is a practice audit: an independent team checks your RHTP spending, documentation, milestones and reports against your actual award terms, the way a state monitor or federal auditor would, so you can fix gaps before they become findings.

How can critical access hospitals and FQHCs prepare for RHTP Year 2?

Under the CMS funding notice, FY2027 (Year 2) state award amounts are set by Oct. 31, 2026, and another $10 billion is available, so CAHs and FQHCs should be tracking their state's next funding cycle now and showing clean Year 1 results.

RHTP Guide: Rural Health Transformation Program Answers for Rural Hospitals, CAHs and FQHCs

Questions answered

How HealthRoots helps

HealthRoots.ai offers one RHTP Grant Compliance, Auditing, Analytics & Reporting package for rural hospitals, critical access hospitals and FQHCs that receive RHTP dollars. We help you stay compliant, audit-ready and on schedule with reporting. The package includes mock grant reviews. It is priced by quote, based on your scope, your state and how often you have to report.

For other funded grant initiatives, HealthRoots works on a gainsharing basis, with no upfront cost and no IT project. Lifetime patient engagement is delivered with our partner Velocity Health.

Get your free readiness check, or reach us at Curious@Velocity.Health or 940.395.5623.

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