On December 29, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced that it will distribute award amounts to all 50 states under the first year of the Rural Health Transformation Program (the “Program”).[i] CMS also established a new Office of Rural Health Transformation (“ORHT”) within the Center for Medicaid that will be responsible for overseeing the program and leading CMS’ engagement with state and local governments and other stakeholders.[ii] The Program is a first of its kind $50 billion initiative to improve and strengthen healthcare in rural communities nationwide via collaboration between CMS and all 50 states to realize their transformative visions for rural health.