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On December 12, 2013, the Commission established the Healthcare Connect Fund, which will fund 65 percent of the cost of broadband services or facilities used for health care purposes by eligible public and not-for-profit health care providers. The Healthcare Connect Fund also permits HCPs to receive support for constructing and owning broadband infrastructure.

On May 20, 2019, the Commission adopted an order to fully fund all eligible services request for the Funding Year 2018 by waiving the rule allowing multi-year commitments and directing USAC to fund all multi-year requests as requests for a single year.

In the August 2019 Rural Health Care Reform Order, the Commission established a Rates Database to determine support in the Rural Health Care Telecommunications Program, targeted funding to rural areas in the most need of health care services funding by prioritizing support based on rurality and whether the area is medically underserved when demand exceeds available funding, increasing the effectiveness of competitive bidding, and streamlining program administration.

In an effort to help ensure that healthcare providers have the resources they need to promote telehealth solutions, the Commission adopted an Order on March 13, 2020, to fully fund all eligible Rural Health Care Program services for Funding Year 2019 with an additional $42.19 million in funding.

In February 2022, the Commission released a Notice of Proposed Rulemaking seeking comment on rate determinations in the Rural Health Care Telecommunications Program, proposing to reform the Commission’s funding cap rules to more efficiently and effectively handle the internal cap on multi-year commitments and upfront payments in the Rural Health Care Healthcare Connect Fund Program, and proposing to simplify invoicing by harmonizing the process between the Telecom Program and the Healthcare Connect Fund Program. 

In January 2023, the Commission released an Order on Reconsideration, Second Report and Order, Order and Second Further Notice of Proposed Rulemaking for the Rural Health Care Program. The Order on Reconsideration granted petitions for reconsideration to restore the prior rate determination rules and eliminate rules requiring the Rates Database for the Telecom Program. The Second Report and Order amended the RHC Telecom Program invoicing processes to eliminate the Health Care Provider Support Schedule and move invoice submission until after services have been provided and also amended the internal cap application and prioritization rules to promote efficiency, reduce delays in funding commitments, and prioritize support for the current funding year. The Order dismissed as moot Applications for Review of the Bureau’s guidance to the Universal Service Administrative Company regarding the Rates Database. The Second Further Notice of Proposed Rulemaking sought comment on fine tuning the rules for determining rural and urban rates in the RHC Telecom Program; reinstating the cap on support for satellite services in the Telecom Program that existed before the adoption of the Rates Database; making it easier for health care providers to receive RHC Program funding as soon as they become eligible; and revisions to data collected in the Telecom Program.

In December 2023, the Commission released a Third Report and Order that permitted conditional approval of eligibility for health care providers that expect to be eligible in the near future to allow them to initiate competitive bidding and request funding; aligned the Service Provider Identification Number change deadline with the invoice deadline; simplified the rules for calculating urban rates for the Telecommunications Program by eliminating the seldom-used standard urban distance” component of the rule that determines urban rates; allowed health care providers to request updates to time periods covered by a competitive bidding exemption to reflect the actual start and end dates of multi-year contracts; shifted to the use of a single universal eligibility form for all program participants; and established a deadline for health care providers to submit invoices for any undisbursed funding commitments without an applicable invoice deadline.