Too pieces of recent legislation and where to find them.
HR 5731 and Section 6209 PAMA
The bill that ended the Fall 2025 government shutdown was HR 5731. Look to Section 6206 to find a 30-day delay in the next implementation of PAMA lab pricing cuts. Find many Medicare payment rules by searching "1834" and find PAMA changes by searching "1834A."
https://www.congress.gov/bill/119th-congress/house-bill/5371/text
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RURAL HEALTH TECHNOLOGY HR 1
This was the "Big Beautiful Bill" and it includes a big beautiful $50 billion dollars for rural health technologies.
https://www.congress.gov/bill/119th-congress/house-bill/1
https://www.congress.gov/bill/119th-congress/house-bill/1/text
Government Summary
- (Sec. 71401) This section provides $10 billion per fiscal year for FY2026-FY2030 for a program that supports the provision of health care in rural areas.
- Under the program, states may apply for financial allotments to improve the access and quality of care of services in rural areas, such as through enhanced technology, strategic partnerships, and workforce training. States must submit detailed rural health transformation plans and certify that no funds will be used to finance the non-federal share of Medicaid or CHIP. The CMS must approve or deny applications by December 31, 2025; states that receive approval do not need to reapply each year. States are not required to contribute any matching funds with respect to program allotments.
- The CMS must award allotments so that 50% of funds are awarded equally among all approved states. The remaining 50% of funds must be awarded based on certain considerations, including the proportion of rural health facilities in the state compared to the number of such facilities nationwide.
- The section additionally provides $200 million for FY2025 for the CMS to implement the program.
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AI Summary (Chat GPT 5)
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Below is a structured ~500-word paragraph-style summary of Section 71401 (Rural Health Transformation Program), integrating the statutory foundations with the implications for med-tech and health-IT suppliers, and concluding with what CMS is likely doing operationally in the first six months and into CY2026.
Section 71401 of the 2025 budget reconciliation law establishes the Rural Health Transformation Program, a $50 billion, five-year mandatory spending initiative aimed at restructuring and modernizing rural health care delivery in all 50 states.
Between FY2026 and FY2030, CMS will allocate $10 billion per year to states that submit approved “rural health transformation plans.” These plans must improve access to rural hospitals and providers; enhance health outcomes; integrate new and emerging technologies; promote regional partnerships and economies of scale; strengthen rural clinical workforce supply; and present credible strategies for long-term hospital solvency.
States may use the funds for at least three of a defined set of “health-related activities,” including evidence-based chronic disease interventions, limited provider payments, consumer-facing technology solutions, the adoption of advanced technologies such as remote monitoring, robotics, AI, and other innovations; workforce recruitment; major information technology upgrades; cybersecurity improvements; and reconfiguration of service lines across the full continuum of rural care.
Only a small fraction of each state's allotment (10 percent for administrative costs, 15 percent for provider subsidies) may go to overhead or direct financial support, ensuring that the majority of funds flow into structural modernization rather than temporary relief.
The implications for medical technology, diagnostics, and health IT suppliers are significant, even though the statute avoids naming specific product categories. The law repeatedly emphasizes “new and emerging technologies,” “technology-driven solutions,” “technology-enabled solutions,” “software and hardware,” “information technology advances,” and “advanced technologies, including remote monitoring, robotics, artificial intelligence.”
This creates a statutory foundation for a wide range of equipment and digital platforms, from connected diagnostic devices and point-of-care instruments to telehealth infrastructure, imaging and pathology informatics, remote monitoring systems, cybersecurity architecture, and cloud-based workflow systems.
For med-tech suppliers, the opportunity lies not in selling individual devices but in positioning integrated solutions that help states satisfy the transformation plan requirements: improving quality, stabilizing rural access, reorganizing service lines, and modernizing workforce-limited settings. For health-IT suppliers, the strongest hooks are in the explicit authorization for software, hardware, interoperability, and cybersecurity upgrades—essentially giving states legal authority and federal dollars to modernize outdated rural hospital infrastructure, strengthen data systems, and deploy digital tools that enable new care models.
The View from CMS
In the first six months after passage (July–December 2025), CMS is likely occupied with program design, application review, and operational scaffolding. Statutory deadlines required states to submit applications by the end of 2025, meaning CMS staff were working intensively to publish guidance, answer technical questions, process fifty state applications, and build the internal analytics necessary to score transformation plans.
CMS also needed to design the allocation formula that splits funds evenly across states and distributes the remainder based on rural population, facility mix, and other factors.
Internally, CMS likely staffed or expanded a cross-agency team, activated its $200 million implementation budget, coordinated with OGC for legal interpretation, and began constructing mandatory reporting templates, oversight frameworks, and technical-assistance resources for states.
Looking into CY2026, CMS will shift from startup activity to execution: approving applications, issuing allotments, conducting early monitoring, and guiding states as they begin procurement and program rollout. CY2026 will be the year when states translate their plans into concrete vendor partnerships for IT modernization, diagnostic upgrades, workforce support technologies, telehealth expansion, and advanced digital tools.
CMS will simultaneously face a growing oversight burden—tracking expenditure, ensuring compliance with allowable uses, and responding to inevitable questions from Congress, GAO, and state stakeholders about whether the $50 billion is producing measurable improvements in rural access and stability.
