Rural Health Care
About Rural Health Care:
- Overview of the Program
- Overview of the Process
- Monthly Conference Calls
- Individual Outreach
- Understanding Audits
- Training Events
- Filing Appeals
- Rural Health Care Pilot Program
Rural Health Care Tools:
Step 5: Comprehensive Rate Comparison Request (Urban/Rural Comparison)
The Rural Health Care Program's telecommunications support is calculated using one of two methods: using only a mileage-based calculation or comparing the differences between urban and rural rates. Participants may choose the method based on which is easier or which provides the most support, according to their own circumstances.
Health care providers that choose urban/rural rate comparison to calculate support will receive support equal to the difference between what they pay (the rural rate) and what they would pay if they were receiving the service in any city in their state with a population of 50,000 or more (the urban rate). Support based on this calculation is requested by completing Block 6 in the Funding Request and Certification Form (Form 466). (For complete instructions, please go to Required Forms.).
To better assist participants in completing Form 466, USAC obtained the rates for the most common telecommunications services in large cities across the country using tariffs filed by telecommunications carriers. These rates can be used to complete Line 40 in Block 6. (Please see "Urban Rates Search" for more information).
The posted urban rates can be used by health care providers that do not have a contract with their telecommunications provider. If you do not see a rate listed for your state, please contact USAC's Customer Service Support Center at 1-800-229-5476.
USAC has compiled contract-based discounted urban rates for health care providers that demonstrate they are paying a discounted contract-based rural rate. In most cases, these rates are lower than the month-to-month rates posted on USAC's website. To use these rates, submit your contract with a completed Form 466. USAC will validate your contract and use the lower rate, if applicable.
In the event that your service is not listed or you believe that you can document a lower urban rate such as a multi-year discounted urban rate (thereby increasing the supportable urban/rural difference), please follow these guidelines in documenting a comparable urban rate. Note: If the urban rate you document is higher than the applicable urban rate in USAC's database, USAC will automatically use the lowest applicable urban rate.
The documented urban rate must resemble the rural rate as closely as possible in terms of length of service agreement, circuit type, bandwidth, and rate elements associated with the circuit. The urban rate must be one that is available to a comparable health care provider located in the urban area. The urban rate must be in use in an urban area in the health care provider's state.
