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The Centers for Medicare & Medicaid Services has announced a new organizational structure, approved by the Department of Health and Human Services and effective Dec. 18, that establishes an Office of Rural Health Transformation.
On Monday, CMS also published a four-part notice of proposed rulemaking on agency information collection activities and its organization and functions that highlight some technical requirements related to the collection of information needed for reporting.
For some proposals, comments may be received by Feb, 20, 2026; others must be received by the Office of Management and Budget by Jan. 21.
WHY IT MATTERS
The announcement about the new rural health oversight structure, published in the Federal Register on Dec. 19, explained how the new Office of Rural Health Transformation is charged with developing grant criteria for the Rural Health Transformation Program as well as partnering with the HHS Office of Acquisition and Grants Management and distributing funding to states.
The $50 billion, 10-year RHTP program, funded by the Working Families Tax Cuts Act as part of the Big Beautiful Bill, encouraged states to organize collaboration between rural health facilities and larger regional systems to share technology and service resources. Applications were due in November and are currently being reviewed by HHS.
According to the notice from CMS, a new Division of State Rural Engagement within ORHT will also serve as the central liaison with stakeholders and government entities implementing grant-funded rural healthcare access initiatives "to ensure progress in improving health outcomes for rural populations."
This division within the new ORHT will oversee compliance with RHTP requirements, monitoring states’ awarded implementations and providing states and rural healthcare stakeholders with guidance, which includes conducting training "for internal and external stakeholders as necessary."
Specifically, the division will conduct readiness assessment reviews as part of ongoing monitoring and oversight. It will also establish policy regarding program monitoring, quality and performance management, and quality improvement for programs and services.
Part of that monitoring ensures resources are appropriately used, and the division is also charged with holding states accountable for achieving the goals outlined in the states' plans.
According to a Statement of Organization, Functions and Delegations of Authority notice published in Monday's Federal Register, the division will partner with the Center for Program Integrity, OAGM and other CMS stakeholder offices on a comprehensive strategic plan, objectives and measures to ensure program vulnerabilities with waste, fraud and abuse are identified and resolved.
Work with the CMS Center for Medicaid and CHIP Services, the Data and Systems Group and the Division of State Systems aims to use existing systems to develop and implement new applications for state system enhancements and quality improvement activities.
"For example, Medicaid Statistical Information System, Transformed-MSIS, and Medicaid & CHIP Program (MACPro), DataConnect, Medicaid and CHIP Data Collection Tool and develop and maintain the system for the collection, organization, review and analysis of data necessary for program integrity, program oversight and administration."
According to the final piece of the four-part NPRM, the new Division of State Rural Engagement will partner with the Center for Program Integrity, OAGM and other CMS stakeholder offices "to develop and implement a comprehensive strategic plan, objectives and measures to ensure program vulnerabilities with waste, fraud and abuse are identified and resolved."
Of note, the Office of Community Services in the HHS Administration for Children and Families is requesting a three-year extension of the Community Economic Development Performance Progress Report, expiring Feb. 28, 2026, with revisions to support a quarterly reporting schedule.
"To reduce the burden for quarterly reporters, OCS will only require grant recipients to complete a subset of items from the CED PPR in the first and third quarters of each project year."
Comments are due Jan. 21, 2026.
THE LARGER TREND
States already had a limited time frame for developing comprehensive plans under the RHTP when the 43-day government shutdown "generated anxiety among potential applicants regarding their applications' viability," explained Valerie Rogers, senior government relations director at HIMSS, parent company of Healthcare IT News.
For states to sustain RHTP goals over the long term, however, holistic approaches to technology and service resource sharing among rural care providers are critical, she said in October.
By stimulating innovative uses of technology, the RHTP could reduce healthcare labor costs and improve access for patients. But states may need to fund capital costs for rural providers unable to finance required system upgrades independently.
There are financial caps and limitations in the RHTP on "specific technology-related expenditures and overall funding distribution," Rogers noted.
ON THE RECORD
"Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency’s functions, the accuracy of the estimated burden, ways to enhance the quality, utility and clarity of the information to be collected and the use of automated following information collections," said CMS officials in the NPRM.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
