Happy New Year to all of our readers! While there are currently no new updates on the
Medicare Telehealth waivers, which are set to expire on January 30, 2026, there are however a few other federal updates that developed at the end of 2025 that are highly noteworthy, and are the focus of this week’s #
TelehealthTuesday newsletter.
Prescribing WaiverAs had been written in recent editions of CCHP’s #
TelehealthTuesday emails, the
Drug Enforcement Administration’s (DEA) extension of the waiver for prescribing of controlled substances via telehealth without a prior in-person visit or meeting one of the existing statutory exceptions has recently been extended for an additional year. Just in the nick of time, on December 31, 2025, the official
notice of the extension appeared in the Federal Register. It is a clean, one-year extension with no new additional requirements needing to be met. This is the DEA’s fourth extension on the prescribing waiver. The new expiration date for the telehealth prescribing waiver is December 31, 2026.
Rural Health Transformation Program (RHTP)HR 1 allocated $50 billion over 5 years to fund projects that will help improve health services in rural communities. The state application and award process had a very aggressive timeline (the District of Columbia and the territories were not eligible to apply), with the original notice of funding opportunity issued September 15, 2025, and applications due on November 5, 2025 . All 50 States submitted applications in early November and awards were made at the end of December 2025.
We now know that all 50 of the state applications were approved and will receive varying amounts of funding. A
press release from the
Centers for Medicare and Medicaid Services (CMS) issued on December 29, 2025 says that, “In 2026, states will receive first-year awards from CMS averaging $200 million within a range of $147 million to $281 million.” The press release contains a breakdown of the amount each state received. The goals of the funding is to bring more care to rural communities, strengthen and sustain rural clinical workforce, modernize rural health infrastructure and technology, improve efficiency, empower community providers, and advance innovative care models and payment reform.
Fifty percent of the funding is distributed equally among all 50 states, whereas the other 50% will be awarded based on additional factors such as rurality and the state’s rural health system, as well as other factors. The
Kaiser Family Foundation (KFF) analyzed the distribution of the funds in a recent report. Among some of the observations made in
KFF’s analysis include notations that Texas, Alaska and California are receiving the largest total amount of funding. Interestingly, while Texas holds the largest and California the fourth largest rural populations, Alaska has the fifth smallest. The KFF analysis notes that the larger allocation of funds to Alaska is likely attributed to the amount of land area in the state, a factor that was taken into consideration under the award formula CMS implemented. The amount allocated per rural resident in each state was also analyzed by KFF noting that Texas, with the largest rural population, will receive only $66 per resident, meanwhile, Rhode Island, with its significantly smaller number of rural residents, will receive $6,305 per resident (KFF does note that Rhode Island is an outlier). Other states with small numbers of rural residents received roughly $1,000 per resident on average.
The applications clearly reflect that most states will take varying approaches in regard to which agency/entity will be administering the funds in each state. On the federal level, CMS announced it will be establishing the Office of Rural Health Transformation which will be overseeing the entire Rural Health Transformation Program. In a
notice published in the Federal Register on December 22, 2025, CMS states that they have established this office, of which the duties will include monitoring the implementation by the states, as well as collaboration with states on their respective state’s project.
As we are still only in the first few weeks of 2026, most states have not begun full implementation yet, however the state implementation process is expected to begin soon. CCHP recommends that those who are interested in the RHTP activities be sure they engage with the agency/entity that will be overseeing the rollout within their state.
CCHP will continue to monitor the progress of the RHTP as well as any other federal telehealth policy developments. To read more about the DEA wavier extension, you can read the
entry in the Federal Register. To read more about the RHTP, the CMS
press release contains specific funding amounts for each state, and
KFF analyzes some aspects of the distribution.