# Rural Health Transformation Program (RHTP) The Rural Health Transformation Program (RHTP), established under Section 71401 of Public Law 119-21 (OBBBA), dedicates $50 billion between FY2026 and FY2030 to transform rural healthcare delivery across all 50 states. RHTP is the largest federal investment in rural health since Medicare Modernization, supporting state-led innovation to stabilize and strengthen rural hospitals, enhance care access and provider sustainability, strengthen workforce capacity, coordinate care, and implement technology-driven solutions. Funds are distributed via cooperative agreements: half is divided equally among approved states; the other half is allocated on a formula considering rural population, proportion of health care facilities in rural areas, and hospital situations serving high shares of low-income patients. Each state receives at least $100 million annually; actual FY2026 awards range from $147 to $281 million. States must implement evidence-based interventions and sustainable rural provider models across at least three approved categories, including prevention, chronic disease management, workforce recruitment, and technology adoption. ## Key facts - Status: Closed - Type: AWARD - Issued by: Centers for Medicare & Medicaid Services (CMS) (Federal) - Posted: 2025-08-15 - Application due: 2025-11-05 - Funding: $50.00B - Eligible applicants: State Government - How to apply: Applications must be submitted via Grants.gov (opportunity number CMS-RHT-26-001) by 11:59 p.m. ET, November 5, 2025. Active SAM.gov and Grants.gov registration is required prior to submission. - Funding source: Rural Health Transformation Program (CMS) - Official source: https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview ## Eligibility Eligible applicants are State governments (all 50 U.S. States and the District of Columbia). Only one application per state will be accepted. States must propose statewide rural health transformation plans in accordance with Section 71401 of Public Law 119-21 (One Big Beautiful Bill Act). ## Requirements Applicants must submit a comprehensive rural health transformation plan addressing statewide strategies for healthcare access, quality improvement, provider sustainability, technology upgrades, workforce development, care coordination, and population health. The application must include a project abstract, transformation plan narrative, budget justification, required assurances and certifications, a statement of compliance with federal reporting requirements, and evidence for at least three approved program purposes (e.g., prevention, chronic disease management, workforce recruitment, technology adoption). SAM.gov and Grants.gov registrations, including UEI, are required prior to submission. ## Required attachments - Project Abstract - Transformation Plan Narrative - Budget Justification/Narrative - Letters of Support (if applicable) - Assurances and Certifications - Statement of Compliance with Federal Reporting Requirements ## Application package and source documents - [US - 2026 - RHT Program Overview](https://www.ruralcarejourney.com/api/documents/e6dd59cf-4228-45ce-8888-31634918e482/file) — official: https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview - [US - 2026 - CMS RHTP](https://www.ruralcarejourney.com/api/documents/e04c82f9-6d26-4d92-8db9-7715c2a38d4a/file) (primary) — official: https://www.cms.gov/files/document/rural-health-transformation-50-state-spotlights.pdf - [US - 2026 - RHTP Post-Award Frequently Asked Questions (FAQs) April 2026](https://www.ruralcarejourney.com/api/documents/d3fa16a9-d71d-47eb-9b02-1215d0f19080/file) — official: https://www.cms.gov/files/document/frequently-asked-questions-april-2026.pdf - [US - 2025 - RHT Program State Project Abstracts](https://www.ruralcarejourney.com/api/documents/000cbce0-ae41-4d85-9293-a7cf9bf7a2e3/file) — official: https://www.cms.gov/files/document/rht-program-state-provided-abstracts.pdf - [US - 2026 - RHTProgram](https://www.ruralcarejourney.com/api/documents/54d829fb-a6b9-4084-9a4b-df3520494e3f/file) — official: https://www.cms.gov/RHTProgram - [US - 2026 - Federal RHTP Summary 2026-2030](https://www.ruralcarejourney.com/api/documents/f07afd35-f004-442f-acb0-212b9886cf68/file) — official: https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2025/rural-health-transformation-program-summary.pdf - [US - 2026 - Federal August 2025 RHTP Summary (Merged from duplicate US federal award)](https://www.ruralcarejourney.com/api/documents/778e0a88-b252-4805-8aef-f8872507de18/file) — official: https://www.finance.senate.gov/imo/media/doc/rural_health_transformation_program_fact_sheet.pdf - [US - 2026 - H.R. 1 Section 71401](https://www.ruralcarejourney.com/api/documents/4cce4c8f-f5e3-4123-8390-888b33d21bae/file) — official: https://www.cms.gov/files/document/chapter-4-protecting-rural-health-hospitals-providers.pdf - [US - 2026 - Federal Category B Funding For Provider Payments RHTP Summary](https://www.ruralcarejourney.com/api/documents/27ee0bae-7dbd-4a1f-bc35-a8bf2d285a7a/file) — official: https://www.cms.gov/files/document/provider-payments-fact-sheet.pdf - [US - 2026 - Notice of Funding Opportunity: RHTP (CMS-RHT-26-001)](https://www.ruralcarejourney.com/api/documents/b254e0cb-f563-423d-9aab-70fea64f1421/file) — official: https://crh.arizona.edu/sites/default/files/2025-09/250915_Rural-Health-Transformation-Program_NOFO.pdf - [US - 2026 - RHT Category E: Workforce Information Guide August 2026](https://www.ruralcarejourney.com/api/documents/948ff19e-8bf4-44dc-a2a2-b79ad4dcc9ca/file) — official: https://www.medicaid.gov/resources-for-states/rural-health/rhtp-resources/CatE-Workforce-Info-Guide.pdf - [US - 2025 - NRHA Statement on CMS' FY 2026 RHTP Awards (NRHA statement on CMS FY2026 RHTP awards)](https://www.ruralcarejourney.com/api/documents/c52d415e-5f83-4e58-9d18-06a2a720cfa1/file) — official: https://www.ruralhealth.us/programs/center-for-rural-health-innovation-and-system-redesign/rural-health-transformation-program/rhtp-press - [US - 2025 - RHTP Post-Award Frequently Asked Questions (FAQs) September 2026](https://www.ruralcarejourney.com/api/documents/4a082dae-4a82-4dd1-b6d3-b9fe9e97d707/file) — official: https://www.medicaid.gov/resources-for-states/rural-health/rhtp-resources/RHTP-Post-Award-FAQ-09-2026.pdf - [RI - 2026 - Request For Proposals (RFP) Finance Manager – RHTP](https://www.ruralcarejourney.com/api/documents/8446a2e3-7a65-49d4-8bd3-037c470c93f4/file) — official: https://stdidrihcaprod.blob.core.windows.net/rihca/documents/RIHCA_Finance-Manager_RHTP_Request-for-Proposals_29SEP26.pdf - [US - 2025 - RHTP Obligated Funds Report Reporting Period: December 29, 2025 - July 31, 2026](https://www.ruralcarejourney.com/api/documents/8f82b18c-19d3-405b-b43b-db6fabd10fa8/file) — official: https://www.medicaid.gov/resources-for-states/rural-health/rhtp-resources/RHTP-Obligated-Funds-10082026.pdf - [US - 2025 - RHTP: Early Implementation Actions and Monitoring Plans](https://www.ruralcarejourney.com/api/documents/4d42d45b-5e82-4c48-a15e-50d8562491e8/file) — official: https://www.gao.gov/assets/gao-27-108853.pdf - [US - 2026 - State Data Maps](https://www.ruralcarejourney.com/api/documents/967a36e4-e959-46e0-bbff-134ed8530cbe/file) — official: https://www.medicaid.gov/resources-for-states/rural-health/state-data-maps - [US - 2025 - Planned State Initiatives Budget Period 1](https://www.ruralcarejourney.com/api/documents/2cb9c89d-af13-4753-9bab-89a43fecd3ea/file) — official: https://www.medicaid.gov/resources-for-states/rural-health/rhtp-resources/rhtp-state-focus-areas.pdf - [NC - 2024 - NC ROOTS Hub Leads](https://www.ruralcarejourney.com/api/documents/77971a88-e5e8-4a6d-a3b4-19116bd51c38/file) — official: http://ncdhhs.gov/about/department-initiatives/rural-health-transformation-program/rural-organizations-orchestrating-transformation-sustainability-roots-hub-leads - [US - 2026 - State Scorecards RHTP Budget Period 1 Annual Report as of July 31, 2026](https://www.ruralcarejourney.com/api/documents/9feeb11d-b566-4855-94bb-57e51a5bcb77/file) — official: https://www.medicaid.gov/resources-for-states/downloads/state-scorecard.pdf More Federal RHTP activity: https://www.ruralcarejourney.com/states/us (markdown: https://www.ruralcarejourney.com/states/us.md) --- Source: Rural Care Journey (RCJ), https://www.ruralcarejourney.com/opportunities/rural-health-transformation-program-rhtp--88d72fff3e — data as of 2026-09-12. Cite the RCJ page for the summary and the linked official source for authoritative terms, deadlines, and amounts.