RHTP Plan Development: CMS Compliance & Rural Health Oversight
By Engineering Solutions, Inc.
At a Glance
- Early November 2025 CMS deadline for plan submission.
- $100M+ annual base allocation per state secured through compliance.
- 10 CMS-allowable activities; states must select at least three.
- ESI delivers CMS-ready plans in 6–12 weeks with proven oversight.
Why RHTP Plan Development Matters
The Rural Health Transformation Program (RHTP), authorized under the One Big Beautiful Bill Act, represents a one-time opportunity for states to secure substantial federal funding. To qualify, states must submit a CMS-compliant plan that demonstrates alignment with at least three of ten allowable activities. Without an approved plan by the federal deadline, base allocations and eligibility for discretionary funds are forfeited.
The CMS Deadline & Compliance Requirements
Applications are due to CMS by early November 2025, with approvals and denials issued by December 31, 2025. Each plan must document the state’s priorities, outline measurable outcomes, and align with CMS’s compliance framework. CMS has made clear there will be no extensions. States must move quickly to authorize procurement and begin plan drafting.
ESI’s Phased Plan Development Framework
Engineering Solutions, Inc. (ESI) applies a proven three-phase model:
- Phase 1 – Plan Development (6–12 weeks): Rapid stakeholder interviews, assessment of rural health priorities, and drafting of a CMS-compliant plan tailored to state needs.
- Phase 2 – Roadmap & Pilots (6–18 months): Launch targeted pilots (e.g., FHIR data hubs, AI monitoring, rural workforce hubs) with compliance oversight and annual CMS reporting.
- Phase 3 – Scale & Sustainability (18+ months): Expand pilots statewide, embed Medicaid reimbursement and value-based payment models, and ensure ongoing CMS documentation.
Innovation as a Compliance Advantage
States that highlight innovation strengthen their competitiveness for discretionary funding. ESI integrates FHIR modernization, AI analytics, and biomedical pilots into RHTP plans. Examples include remote monitoring for chronic disease, AI-enabled hospital solvency dashboards, and telehealth command centers. Each innovation is tied to measurable KPIs and aligned with CMS reporting structures.
Trusted Oversight & Proven Results
ESI has been recognized by CMS officials for regulatory mastery, with a track record that includes leading Oregon’s $350M Medicaid modernization to approval. Our FEMA-CERT readiness and experience with emergency procurement allow us to mobilize within days to meet the accelerated federal schedule.
Next Steps
States cannot afford to wait. Authorizing plan development now protects eligibility and ensures compliance with CMS’s immovable deadline.
