There are rules, and there are exceptions.  This week we’re making some common-sense exceptions so that some 235 health care providers can continue to provide high-quality health care to rural America.

Rural Americans face unique challenges today in accessing hospitals, doctors, and health care services.  The FCC’s Rural Health Care (RHC) program helps address these challenges by providing discounts for communications services to health care providers in rural areas.  Health care providers use these connections to provide services such as telehealth, specialist consultations, and community education.  As health care providers continue to find better ways to serve rural patients, we want to make the RHC program responsive to their needs.
 
So in the name of being responsive, this week we proposed to make some exceptions to help certain health care providers that were facing loss of the RHC support they’ve had for years.  Our proposal to make them permanently eligible is known in regulatory parlance as “grandfathering.”  It’s a long story, but back in 2005, the FCC changed its definition of “rural” in a way that would have made some previously qualifying health care providers ineligible for discounts.  We temporarily “grandfathered” these providers, in order to allow them to continue receiving discounts while we evaluated the impact of the rule change.  
 
Six years later, grandfathered providers have shown that they have been and continue to play a key role in delivering health care services to patients living in surrounding rural regions.  For example: 
  • In Nebraska, three grandfathered hospitals participate in the Nebraska Statewide Telehealth Network, a model statewide network in which 80 percent of participating health care providers qualify as “rural” under our rules.  RHC discounts for the grandfathered hospitals helps to connect 32 eligible rural hospitals and eight local health departments to the NSTN.  
  • In Alaska, the Tanana Chiefs Conference receives support for a 362-mile communications link from Fairbanks to Anchorage that facilitates health care access for 25 Interior Alaska communities.  
  • In Virginia, grandfathered health care providers are taking part in projects to create a demonstration rural tele-stroke network and to deliver high risk obstetric services to rural areas. 
We are excited about the critical services provided by grandfathered facilities.  Examples include emergency services, preventative care, counseling, oncology, psychiatry, neurology, tele-trauma, and teleradiology.  These providers they rely on RHC discounts to make their telehealth programs affordable.  
 
In the Order and Notice of Proposed Rulemaking adopted this week, the Commission asks if it is time to give these providers some certainty by granting them permanent eligibility for RHC discounts.  It could help them move forward with many important initiatives, better respond to the needs of patients, and continue to provide innovative telehealthcare to rural America in a cost-effective way.  Until then, today’s Order will keep RHC support flowing until we make our final decision.