FCC Proposed Rule on Rural Telehealth: What Practices Should Check

The FCC's August 31, 2026 proposed rule, Promoting Telehealth in Rural America, seeks comment on rural rate methods, backup services, an RHC Program eligible services list, funding-request metrics and evergreen contracts.

On August 31, 2026, the Federal Communications Commission (FCC) published a document titled "Promoting Telehealth in Rural America" in the Federal Register as document 2026-17767 ^[1]. The document is designated a proposed rule, and its summary states that the Commission seeks comments on six areas ^[1]. The summary ties two of those areas to the Rural Health Care (RHC) Program. The others concern rural telecommunications rates, backup services, contract approval and a reporting requirement ^[1].

What the proposal covers

The scope of the "similar service" and "rural area comparability" requirements ^[1].
Possible improvements to, or replacements of, the existing cost study method used to determine rural telecommunications rates ^[1].
Possible methods of promoting lower-cost technologies intended to provide backup services ^[1].
A proposal to establish an eligible services list for the RHC Program ^[1].
Whether to adopt performance metrics to expedite the processing of RHC Program funding requests ^[1].
Whether to eliminate the approval requirement for evergreen contracts and an annual report requirement ^[1].

The summary frames these items with different degrees of firmness. It calls only the eligible services list "a proposal" ^[1]. It describes the rate-method and backup-service items as "possible" approaches. It frames the performance metrics and the evergreen contract and annual report changes as questions of "whether" to act ^[1]. The summary does not define "similar service," "rural area comparability" or "evergreen contracts." Readers who need the FCC's definitions have to consult the full document ^[1].

Who it affects

The summary does not identify the parties the proposal would affect ^[1]. It names the RHC Program in two items: the proposed eligible services list and the possible performance metrics for RHC Program funding requests ^[1]. Four items remain: the similar service and rural area comparability requirements, the cost study method, backup services, and the evergreen contract and annual report requirements. For these, the summary does not state which program or which participants they apply to ^[1]. It also does not list which categories of health care providers are eligible for the RHC Program ^[1]. To establish whether a given item applies to an organization, readers have to consult the full document ^[1].

Dates that matter

The publication date is August 31, 2026 ^[1]. The summary gives no comment deadline, no reply-comment deadline and no proposed effective date ^[1]. A practice that intends to comment should take those dates from the full Federal Register document rather than from secondary accounts ^[1].

What a practice should check

Participation. Confirm whether the organization currently participates in the RHC Program or plans to file a funding request. The possible performance metrics concern the processing of RHC Program funding requests ^[1].
Contracts. Identify any evergreen contracts the organization holds. The FCC is asking whether to eliminate the approval requirement for evergreen contracts ^[1].
Reporting. List the annual reports the organization files. The FCC is asking whether to eliminate an annual report requirement, and the summary does not say which report it means ^[1].
Services in use. Compare current and planned services against whatever eligible services list the full document proposes for the RHC Program ^[1].
Backup connectivity. Review whether the organization relies on, or is planning, backup services. The FCC is seeking comment on methods of promoting lower-cost technologies for that purpose ^[1].
Rates. If rural telecommunications rates matter to the organization, review the cost study method and the comparability questions in the full text ^[1].
Comment. Decide whether to file comments, and confirm the deadline in the full document ^[1].

Context from other August 2026 federal rules

The FCC document is a proposed rule from a communications regulator. Two health-sector documents published the same month are final rules ^[1]^[2]^[3]. On August 4, 2026, the Centers for Medicare & Medicaid Services (CMS) published a final rule. It revises the Medicare inpatient prospective payment systems for acute care hospitals and updates payment policies and annual payment rates for long-term care hospitals. It also changes requirements for certain quality programs ^[2]. In the same document, ONC adopts certain health information technology standards and specifications on behalf of the Department of Health and Human Services (HHS) ^[2].

On August 3, 2026, CMS published a final hospice rule for fiscal year 2027 ^[3]. Among other changes, it finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election ^[3].

Limitations

This brief relies on the Federal Register summary of document 2026-17767, not on the full proposed regulatory text ^[1]. It therefore cannot report the following ^[1]:

comment or reply-comment deadlines ^[1];
the services on the proposed eligible services list ^[1];
the FCC's definitions of the requirements it names ^[1];
the parties to which each item applies ^[1];
any cost or burden estimates ^[1].

The CMS rules are cited only to show what else was published that month. Their summaries do not mention the FCC proposal or the RHC Program ^[2]^[3].