Providers, Advocates Welcome Proposed Changes to RHC Funding Mechanism

Rural healthcare program participants and advocates welcomed FCC proposals on the program's rate determination rules, whether to reinstate the support cap for satellite services, and how providers can receive funding as soon as they become eligible. Comments were posted through Tuesday in docket 17-310. Commissioners adopted the NPRM in January, which also sought comments on how to revise the FCC’s Form 466 to improve data collection efforts (see 2301260041).

The rural healthcare program is "invaluable for rural health care providers to establish telecommunications and broadband services necessary for providing health care in rural communities," said the National Rural Health Association. NRHA suggested the FCC use a "cost-based rate method for any application that exceeds a threshold" and require service providers to submit a justification of their requested rural rate. The group also backed prioritizing multiyear contracts for rural healthcare providers in the Healthcare Connect Fund (HCF) program, saying the FCC should "release the data showing how much of the HCF funding is going to urban providers" because they can apply through a consortium.

Don't rely on urban rates from the rates database, said the Schools, Health & Libraries Broadband Coalition. "These unreliable and potentially harmful rates should not be used" in the telecom program, the group said, adding the FCC should "continue to allow program participants to use publicly available urban rates" from the Universal Service Administrative Co.'s open database and E-rate program. SHLB backed basing urban rate calculations on rates provided in a city and expanding the definition of an urban area to increase the number of qualifying areas. The group also raised concerns about additions to the annual Form 466 data collection, saying it would "hamper participation" in the telecom program.

Eliminating the rates database "removes the uncertainty created by that methodology for determining the rural rate under the telecom program, which yielded unpredictable and economically irrational results, especially for areas with very thin demand," said GCI Communication Corp. The provider asked the FCC to shift to competitive bidding "where possible" because "regulatory mechanisms to set ex ante rate caps will be both burdensome and prone to errors."

The Alaska broadband provider urged the FCC not to "arbitrarily" place caps on satellite rates: "For many remote communities in Alaska, satellite services represent the only way to provide reliable backup for critical communications needs." Caps on these services are "likely to drive the permitted rural rates below even incremental cost," GCI said. A cap is also "not necessary to control demands on the Universal Service Fund," it said, because "recent increases in costs are likely to stabilize as additional capacity from new satellite constellations and terrestrial fiber networks provide alternatives for route diversity."

Telehealth was "particularly integral to providing care to patients" during the COVID-19 pandemic, said the American Association of Nurse Practitioners (AANP). The NPRM's proposals would "make it easier for health care providers" to receive program support as soon as they become eligible because current rules limit a provider's ability to complete the competitive bidding process if they are not an eligible provider yet, the group said. The group backed the proposal to allow program applicants with conditional eligibility to move forward and submit a request for funding, saying it would "improve flexibility for providers."