June 19, 2026 - WASHINGTON, D.C. — On Thursday, U.S. Senators Susan Collins and Michael Bennet (D-CO) led a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz urging the agency to make adjustments to support the successful implementation of the Rural Health Transformation Program (RHTP). Senators Alex Padilla (D-CA) and John Hickenlooper (D-CO) also signed the letter.

John C. Fremont Hospital in Mariposa County

In their letter, the Senators emphasized that the RHTP provides a unique opportunity to address long-standing challenges to better position rural hospitals to serve their communities for years to come.

Rural health care systems across the country continue to face significant strain. Since 2010, more than 200 rural hospitals nationwide have closed or reduced inpatient services, and more than 45 percent of remaining rural hospitals are operating in the red. With $50 billion in RHTP funding now being distributed and all 50 states receiving initial allocations, the Senators warned that current implementation guidance may unintentionally disadvantage many rural hospitals and clinics—the very frontline providers most in need of support.

“In rural communities across the country, hospitals and clinics serve as the backbone of local health care systems delivering emergency care, supporting maternal health, treating chronic illness, and standing ready to respond when lives are on the line,” the Senators wrote. “At a time when many rural hospitals continue to face workforce shortages, rising operational costs, declining reimbursement, and persistent financial instability, it is essential that implementation of the RHTP reflects the realities facing rural providers on the ground.”

“We believe that implementation can be improved further by lifting the cap on infrastructure and capital improvements for rural facilities, as many need significant improvement and equipment upgrades,” they continued. “We also believe that clarifying the permissibility of direct payments to providers is crucial.”

“Rural Americans deserve reliable access to high-quality care close to home. Our recommendations aim to strengthen the hospitals and providers that communities rely upon in moments of crisis and every day in between. Low reimbursement rates from public payers paired with low volumes are a major contributor to rural hospital financial instability. RHTP provides a unique opportunity to address these long-standing challenges and set rural hospitals up for success on their road to transformation,” the Senators concluded.

Click here for the complete text of the letter.

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The RHTP represents the largest single federal investment in rural health care in more than two decades. Senator Collins proposed the funding during negotiations over amendments to the One Big Beautiful Bill Act. She successfully pushed to expand the program to $50 billion and ensure that a broader range of rural providers would be eligible for support, despite voting against the One Big Beautiful Bill Act.

Last December, she announced that Maine will receive $190 million in first-year funding through the RHTP, and, earlier this year, Senator Collins intervened to preserve Maine’s first-year funding award. Alerted by CMS that Maine’s funding was in jeopardy, Senator Collins stressed to CMS Administrator Oz how critical the funding is to Maine’s rural hospitals and other health care providers serving rural Mainers. She asked that CMS work with the state to bring it into compliance, which occurred.

The letter is endorsed by the National Association of Rural Health Clinics, the National Rural Health Association, and the Federation of American Hospitals.

“The National Rural Health Association supports Senators Bennet and Collins’ bipartisan letter to CMS addressing methods to strengthen the Rural Health Transformation Program (RHTP). In order to protect the integrity of this historic investment, it is critical that CMS ensure funds reach the rural health facilities they were intended for. Providing greater flexibility for provider payments, workforce investments, and health information technology, while ensuring smaller and independent rural providers can meaningfully access funding opportunities, will help RHTP fulfill its purpose of strengthening rural health care systems and improving access to care in rural communities,” said Alan Morgan, CEO of the National Rural Health Association.

“For this unique investment to be truly transformational, it is imperative that these dollars flow to rural providers, including the 5,800+ CMS-certified Rural Health Clinics across the country. We greatly appreciate the leadership of Senators Bennet and Collins to ensure necessary flexibilities in implementation to ensure these funds go where they are needed most,” said Sarah Hohman, Director of Government Affairs for the National Association of Rural Health Clinics.

Source: Senator Susan Collins