The Federation of American Hospitals (FAH) recently sent a letter to CMS Administrator Dr. Mehmet Oz outlining recommendations for implementing the Rural Health Transformation Funding (RHTF) included in the One Big Beautiful Bill Act (OBBBA).

FAH emphasized that while the RHTF is a critical first step, CMS must act swiftly and strategically to ensure rural hospitals can sustain services, retain staff, and modernize care delivery.

Key FAH recommendations include:

• Prioritize direct payments to rural hospitals for essential services like emergency care, behavioral health, obstetrics, and specialty care.
• Ensure eligibility for all rural hospitals—regardless of ownership or tax status.
• Minimize administrative burden—avoid requiring new programs to access funds.
• Allow states to update their plans over time as rural needs evolve.
• Preserve existing federal support by preventing RHTF dollars from triggering Medicare or Medicaid payment reductions.
• Make the state and CMS processes transparent, with clear application guidelines, evaluation criteria and a pathway for states to revise denied applications.

Read the letter here.