Maryland received $168.2 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 44th of 50 states. The Maryland Department of Health (MDH) runs the program, which funds three initiatives across Maryland's 18 state-designated rural counties, from health workforce pipelines and primary care access to healthy food.
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
The award is fixed for the year. Spending moves every quarter, so Maryland's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Maryland's RHTP funds three initiatives, which the state calls pillars: workforce, access and innovative care, and healthy eating. Each pillar has Immediate Impact Funds for ready-to-start work and Transformation Funds awarded competitively, and every Maryland funding opportunity maps to one of the three.
Apprenticeships, peer recovery and allied health training, Area Health Education Centers including a new Southern Maryland AHEC, provider recruitment and retention, and a statewide health workforce data clearinghouse.
Primary care practice expansion, school-based health centers, mobile health and community paramedicine, behavioral health, pre-hospital blood transfusion, CRISP data connections and telehealth, and preparing providers for value-based care.
Cold storage for farms, grants for small grocers and mobile markets, food hubs, local food purchasing and nutrition education by local health departments.
Recipients by initiative are in Maryland's section of the RHTP Year One Report.
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a Maryland solicitation.
Maryland's program covers the 18 counties that state law defines as rural, out of 24 county-level jurisdictions including Baltimore City: Allegany, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Garrett, Harford, Kent, Queen Anne's, Somerset, St. Mary's, Talbot, Washington, Wicomico and Worcester. Almost a third of Marylanders live in these areas. Each funding opportunity states its own geographic requirements.
View MDH's rural counties map →Maryland providers apply through funding opportunities from MDH and its partner agencies, such as the Maryland Department of Labor, the Maryland Health Care Commission and CRISP, posted on MDH's RHTP funding opportunities page and run through each partner's own process, including eMMA, the state's procurement site. Most Year 1 rounds have closed, and Year 2 dates have not been announced. Providers and vendors don't apply to CMS directly.
Federal terms follow the money down to every Maryland recipient.
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Maryland's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Maryland's Year 1 award, the maximums are:
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Maryland's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Maryland made no concrete state policy commitments in its application, according to CMS, so none of its funding depends on new laws or rules. Its plan and budget do make five program commitments. One is done.
Run a volunteer advisory committee whose quarterly meetings are open to the public
Public meetings under way; September 10, 2026 agenda postedRequire every RFP and RFA to address how the work continues after RHTP funding
Require grant recipients to set evidence-based measures and milestones in their agreements
Require five-year rural service commitments where the plan calls for them
Spend all Budget Period 1 funds
Funds had to be obligated by Oct 30, 2026Maryland already belongs to the physician, nurse and psychology licensure compacts. It has not joined the EMS or physician assistant compacts.
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Use the numbers in Maryland's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Obligated money is signed to a contract or grant. Cash reaches recipients later.
The data covers December 29, 2025 to July 31, 2026, as Maryland reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
The CMS report has no recipient column. Search Maryland's line item descriptions by name.
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
The Maryland Department of Labor announces $16.4 million to 39 organizations for health career pathways and the RISE recruitment and retention program.
MDH announces $80 million to 41 grantees to expand rural primary care, behavioral health and dental services.
CRISP opens the Rural Health Connectivity Program, paying rural providers up to $40,000 to connect to the state health information exchange.
MDH releases a combined Transformation Fund RFA for service expansion, behavioral health and innovative care.
CMS approves Maryland's revised Year 1 budget and releases the funds.
Governor Moore announces Maryland's $168 million Year 1 award.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Most of Maryland's Year 1 money sits in the access and care pillar, about $126 million. The $73 million combined Transformation Fund round, run with the Health Services Cost Review Commission, funded service expansion, behavioral health and value-based care readiness. Expect Year 2 rounds to follow the same pillars.
Maryland routes funding through named partner agencies, including MD Labor, MHCC, HSCRC, CRISP, the Maryland Department of Agriculture and the Rural Maryland Council, each with its own process. Technology vendors can list themselves in MDH's Rural Health Vendor Directory. Telehealth, health data connections, mobile health and workforce training are the most active lanes.
Build tracking for the measures Maryland reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Maryland's annual rescoring. Year 1 funds must be spent by September 30, 2027.
The Maryland Department of Health (MDH) runs Maryland's Rural Health Transformation Program through its State Office of Rural Health, using federal funding from the Centers for Medicare & Medicaid Services (CMS). MDH manages the state's plan, works with partner agencies that post funding opportunities and answers questions at mdh.transformruralhealth@maryland.gov. The program is Maryland's share of the $50 billion federal Rural Health Transformation Program.
Maryland received $168,180,837 for Year 1 of the Rural Health Transformation Program, 44th of 50 states. Every state got $100 million in baseline funding, and the rest of Maryland's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Maryland's progress.
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Maryland's award each year, about $33.6 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to Maryland's plan, up to 15% of the award each year, about $25.2 million in Year 1. They can't raise rates for services providers already bill.
The RHTP Year One Report tracks how much of Maryland's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. Awards announced after July 31, such as $80 million in August 2026 for rural primary care, behavioral health and dental services and $16.4 million in October 2026 for workforce programs, will appear after the next CMS refresh.
These RHT Alliance members serve Maryland providers, with support that spans virtual nursing, virtual care, remote monitoring, health data, diagnostics, patient education and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.