The One Big Beautiful Bill Act (OBBBA) was signed into law 7/4/25. Title VII, Sec. 71401 Rural Health Transformation Program. RHTP allocates $10 billion per year for five fiscal years 2026-30. Half will be distributed to states equally, $100 million/yr X 5, upon approval by the Centers for Medicare & Medicaid Services (CMS) of each state’s RHTP Plan.
The Governor’s Office leads Arizona’s response to the RHTP opportunity. CMS posted the notice of funding opportunity to states on 9/15/25 2025. States must submit their RHTP Plan by 11/5/2025. CMS must approve or deny state proposals by 12/31/25. States must submit an annual expenditure report (Fed FY: Oct 1 to Sept 30). States cannot use RHTP funding to finance the non-federal Medicaid match requirement. Administrative costs must be <10% of a state’s RHTP allotment.
Rural Health Transformation Program Notice of Opportunity
Notice of Funding Opportunity from Centers for Medicare and Medicaid Services
Application due November 5, 2025
Arizona's Rural Health Safety Net
Arizona Critical Access Hospitals, IHS and Tribal Facilities, Rural Health Clinics, FQHCs (updated August 2025)
What is Rural?
Defining Rural: Arizona's Rural Health Transformation Program Opportunity
Arizona Critical Access Hospitals (CAHs)
Critical Access Hospitals and Rural Health Transformation Program Opportunities