CMS launches Office of Rural Health Transformation to Oversee $50 Bn Rural Health Program

The office will serve as the primary liaison for the $50 billion Rural Health Transformation Program (RHTP), a decade-long federal initiative aimed at improving healthcare access and infrastructure in rural areas.

The Centers for Medicare & Medicaid Services (CMS) has launched a new Office of Rural Health Transformation (ORHT) under a revised organizational structure approved by the Department of Health and Human Services, effective December 18. 

The office will serve as the primary liaison for the $50 billion Rural Health Transformation Program (RHTP), a decade-long federal initiative aimed at improving healthcare access and infrastructure in rural areas.

The announcement was published in the Federal Register on December 19, outlining ORHT’s role in coordinating, overseeing, and driving rural healthcare policy nationwide. The office is responsible for developing grant criteria for the RHTP, working with the HHS Office of Acquisition and Grants Management, and distributing funds to participating states.

The RHTP, funded through the Working Families Tax Cuts Act as part of the Big Beautiful Bill, encourages states to promote collaboration between rural healthcare providers and larger regional systems to share technology and service resources. Applications for the program closed in November and are currently under review by HHS.

As part of ORHT, CMS has also established a Division of State Rural Engagement. The division will act as the central point of coordination between CMS, states, and other stakeholders implementing grant-funded rural healthcare initiatives. According to CMS, the division will oversee compliance with RHTP requirements, monitor state-level implementation, and provide guidance and training to both internal and external stakeholders.

The division’s responsibilities include conducting readiness assessments, establishing policies for program monitoring, quality and performance management, and supporting quality improvement activities. It will also hold states accountable for meeting the objectives outlined in their approved plans and ensure federal resources are used as intended.

CMS stated that the Division of State Rural Engagement will work closely with the Center for Program Integrity, the Office of Acquisition and Grants Management, and other CMS offices to identify and address potential risks related to waste, fraud, and abuse. The division will also collaborate with CMS data and systems teams to leverage existing Medicaid and CHIP platforms for program oversight, data collection, and quality improvement.

Separately, CMS released a four-part notice of proposed rulemaking related to agency information collection and organizational functions. Comment deadlines vary, with some proposals open for feedback until February 20, 2026, and others requiring submission to the Office of Management and Budget by January 21, 2026.

CMS officials said the proposed information collection updates are intended to support program oversight and administrative functions while seeking public input on reporting burden and data utility.

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