Notice of Supplemental Funding, Medicare Rural Hospital Flexibility Program
HRSA is providing additional fiscal year 2026 funding under the Medicare Rural Hospital Flexibility (Flex) Program using the program's established funding methodology, including...
Health Resources and Services Administration (HRSA), Department of Health and Human Services.
ACTION:
Notice of supplemental funding.
SUMMARY:
HRSA is providing additional fiscal year 2026 funding under the Medicare Rural Hospital Flexibility (Flex) Program using the program's established funding methodology, including a baseline increase for all recipients and an additional adjustment for states with newly designated Critical Access Hospitals (CAHs). This funding will support state efforts to strengthen CAHs, improve quality and performance, and sustain access to essential rural health care services.
FOR FURTHER INFORMATION CONTACT:
Sheena Johnson, Deputy Division Director, Hospital State Division, Federal Office of Rural Health Policy, HRSA, at
sjohnson@hrsa.gov
and (872) 271-6370.
SUPPLEMENTARY INFORMATION:
Intended Recipients of the Award:
2 Flex Program Recipients.
Amount of Non-competitive awards:
2 awards totaling $620,742.
Project Period:
September 1, 2026, to August 31, 2027.
Table 1—Recipients With Funding Increases Exceeding 25 Percent
Grant number
Award recipient name
State
Award
amount
U2WRH33293
Alabama Department of Public Health
AL
$146,403
( printed page 57620)
U2WRH33313
Texas Department of Agriculture
TX
474,339
Justification:
HRSA received increased funding in the Consolidated Appropriations Act, 2026, (
www.govinfo.gov/content/pkg/PLAW-119publ75/pdf/PLAW-119publ75.pdf), H.R. 7148, for the Medicare Rural Hospital Flexibility Program. The Flex Program supports states in strengthening CAHs, improving quality and performance, supporting financial and operational improvement activities, and sustaining access to essential rural health care services. For fiscal year 2026, HRSA will apply a 2.5 percent funding increase to all 45 Flex Program recipients and an additional increase of 5 percent for each newly designated CAH in a state. This approach provides all Flex recipients with a baseline increase while directing additional resources to states with expanded program responsibilities due to CAH growth.
As a result of this increase, the two recipients listed in Table 1 will receive additional funding due to the number of newly designated CAHs in their states. The additional funds will provide additional support to strengthen CAHs, improve quality and performance, support financial and operational improvement activities, and sustain access to essential health care services in rural communities.
42 U.S.C. 1395i-4(g)(1)-(2)
www.ssa.gov/OP_Home/ssact/title18/1820.htm