Q: what is the #1 thing you’d like me to cover in our next quarterly report? Reply back.
In this issue:
CMS publishes updated Rural Health Transformation Program Post-Award Frequently Asked Questions (FAQs), September 2026
South Dakota has its Rural Health Data Atlas–Informatics Services and Medicaid PACT RFPs open, due September 28 and October 2
Iowa gets CMS’s first State Spotlight for its Combat Cancer Health Hub Program, and its Healthy Hometowns dashboard shows $32,850,309.82 obligated to the hubs and $0 spent
South Dakota awards 12 CCBHC modernization and infrastructure grants, more than $13 million, with no amounts by clinic
Delaware awards $22.69 million to its three FQHCs
Arkansas awards $54,685,068.84 in Year 1 RISE AR and HEART funding to 38 organizations
CMS publishes updated Rural Health Transformation Program Post-Award Frequently Asked Questions (FAQs), September 2026
Dated September 23, it replaces the April edition and opens with a change log: 49 new questions, 2 updated. Quietly linked from the Medicaid CMS resources page and Maryland’s RHTP Procurement page, stamped 09-24-2026. The answers that change what a subrecipient or vendor can expect:
No CMS approval of subaward budgets before signing; states upload final subaward and contract information as a grant note after selection.
States must disburse drawn-down funds, “including both up-front advance payments and reimbursements,” within 3 business days.
A subrecipient’s administrative rate can exceed 10%, as long as the state’s cumulative admin across the whole award stays at or under 10%.
Doulas are nonclinical, so no 5-year service commitment. Community paramedics are clinical, so they carry one.
The 5-year commitment can’t be served by telehealth from a non-rural site, can’t be served in a neighboring state, and CMS may recoup 100% if a provider walks without extenuating circumstances, prorated if there are.
CMS tells states to collect each obligated provider’s tax ID and NPI “to match against available claims data.”
Non-rural FQHCs can be funded if their services “clearly benefit rural residents.”
The one that didn’t change: no extension on the obligation deadline.
South Dakota has its Rural Health Data Atlas–Informatics Services and Medicaid PACT RFPs open, due September 28 and October 2
File this under new to me. Both went up on the state posting board mid-month, and the September RHT Funding Forecast (updated 09/15/2026, posted yesterday) is where they surfaced. Against the August 19 edition, it adds the Informatics RFP and flips PACT from UPCOMING to OPEN:
26RFP-27-09RHT-025, Rural Health Data Atlas–Informatics Services, posted September 14, due September 28, 5:00 PM CT. The second Data Atlas procurement; the Data Visualization & Analysis Platform (26-09RHT-021) closed August 31.
26RFP-27-09RHT-026, Rural Health–Medicaid Primary Accountable Care Transformation (PACT), posted September 10, due October 2, 11:59 PM CT. The forecast pegs PACT Provider Value-Based Quality Payments at $7M first year. The Q&A cutoff was September 10 at 9:34 AM, 55 minutes after posting.
Still UPCOMING: Population Health and Case Management Tools, $3M first year.
Both are invitation only on ESM, and the documents sit behind a supplier login. South Dakota’s own annual report lists PACT at zero payers aligned on payment methodology and zero Medicaid recipients enrolled in case management as of July 31.
Iowa gets CMS’s first State Spotlight for its Combat Cancer Health Hub Program, and its Healthy Hometowns dashboard shows $32,850,309.82 obligated to the hubs and $0 spent
CMS opened a State Spotlights page yesterday and led its September RoundUp email with it:
Iowa is taking the fight to cancer through its $11 million RHTP-funded Combat Cancer Health Hub Program. Five recently announced awardees will work to expand access to cancer care in rural areas through partnerships, telehealth, workforce recruitment, equipment purchases, and other investments.
CMS doesn’t name them. Iowa did, on June 18: Ottumwa Regional Health Center, Wayne County Hospital, Shenandoah Medical Center, Greater Regional Medical Center and Mary Greeley Medical Center.
That same release launched the Power BI dashboard we flagged June 19 and never walked. It was last updated September 17. What it says now:
All $209,040,063.71 of Year 1 obligated, $13,700,056.62 spent, 6.6%
Combat Cancer: $44,811,984.82 obligated, $867,300.51 spent
Combat Cancer Health Hubs: $32,850,309.82 obligated, $0.00 spent. CMS’s $11 million doesn’t match any line.
The hub-and-spoke map carries seven hub networks: Mary Greeley, MercyOne Des Moines, MercyOne North Iowa, Methodist Jennie Edmundson, Ottumwa Regional, Shenandoah and Wayne County. Greater Regional isn’t one of them.
The other pages break out awards by county and scope of work, Best and Brightest equipment and workforce recruitment dollars by county, and Centers of Excellence by specialty.
