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RHTP state profile · Virginia
Virginia Rural Health Transformation Program
Virginia received $189.5 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 37th of 50 states. The Virginia Department of Medical Assistance Services (DMAS) runs the program, which funds four initiatives across Virginia's 76 rural localities, from health technology and workforce pipelines to mobile care, maternal care and prevention.
Year 1 awards, all 50 statesVA: $189.5M
Texas $281.3MNew Jersey $147.3M
$189.5MYear 1 award, 37th of 50
4Funded initiatives
76 / 133Virginia localities are rural
DMASVirginia Department of Medical Assistance Services
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Virginia's program at a glance
The award is fixed for the year. Spending moves every quarter, so Virginia'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.
Year 1 award$189,544,888, 37th of 50 states
Run byVirginia Department of Medical Assistance Services
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives4
Rural localities76 of 133
Spending data through July 31, 2026Virginia's section of the Year One Report →Initiatives
What does Virginia's RHTP fund?
Virginia's RHTP, which the state calls VA Rural Vitality, funds four initiatives across technology, workforce, care delivery and prevention. DMAS routes the money through key implementation partners, and every funding opportunity maps to a sub-initiative under one of the four.
Homegrown Health Heroes
Rural health career pathways, including physician residency slots, community college allied health programs, Earn to Learn apprenticeships and high school career pipelines.
Connected Care, Closer to Home
Mobile and hybrid care, community paramedicine and maternal care that bring services closer to rural residents.
Live Well, Together
Prevention through Food is Medicine programs, Active Kids play spaces, consumer health technology and integrated care for people enrolled in both Medicare and Medicaid.
Recipients by initiative are in Virginia's section of the RHTP Year One Report.
Source documents
Virginia's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a Virginia RFA.
PDFDMASVirginia RHT Program Project NarrativeThe full VA Rural Vitality plan from DMAS, including all four initiatives, the state's rural definition and its policy commitments.PDFDMASVA Rural Vitality Application OverviewDMAS's three-page summary of the plan and its four initiatives.PDFVirginia RHTRHT RFA NavigatorEvery Virginia RHT funding opportunity by sub-initiative, with application windows, award sizes and contacts.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Virginia's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural locality (76)Other localities (57)
Eligibility
Which Virginia localities are eligible for RHTP funding?
Virginia's program treats 76 of its 133 localities, counties and independent cities, as rural, using the federal HRSA Federal Office of Rural Health Policy definition. Funded projects must be in one of those rural localities or show that they serve their residents, and the state groups the 76 into six regions, from the Eastern Shore and Northern Neck to Southwest Virginia. Each RFA states its own geographic requirements.
View Virginia's rural localities →How to apply
How can Virginia providers apply for RHTP funding?
Virginia providers apply through requests for applications (RFAs) from the program's key implementation partners, such as the Virginia Department of Health, the Virginia Health Care Foundation and the Virginia Hospital and Healthcare Association Foundation, all listed on the state's Ways to Apply page. Five regional Mobile and Hybrid Care RFAs, run through planning district commissions, are open October 23 to November 23, 2026. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the four, and each sub-initiative has its own partner and RFA.
- Check the RFA Navigator.It lists application windows, award sizes and the contact for each RFA. Submit a separate application for each RFA you pursue.
- Register in SAM.gov.It is standard for federally funded grants and contracts.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year.
- Ask the program directly.Use the contact form on the Virginia RHT site, or the contact named in each RFA.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Virginia recipient.
Grants and contracts carry different obligations
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.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can Virginia's RHTP funding pay for?
Virginia's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Virginia's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $37.9M
Provider payments15% of award
About $28.4M
Administrative costs10% of award
About $19.0M
Rural Tech Catalyst Fund10% or $20M, whichever is less
About $19.0M
Replacing an existing EMR system5% of award
About $9.5M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Virginia'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.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
Virginia's policy commitments carry deadlines
Virginia committed to three policy actions in its application. Two are done. CMS can reduce or recover funding if the other slips.
SNAP sugary drink restriction
Obtain a USDA waiver to exclude sweetened beverages from SNAP purchases
USDA approved December 10, 2025; the restriction on sweetened carbonated drinks took effect November 1, 2026Nutrition education for physicians
Require nutrition continuing medical education by regulation
Board of Medicine adopted one hour of nutrition education October 30, 2025, starting with the 2028 to 2029 renewal cyclePresidential Fitness Test
Bring back the Presidential Fitness Test in all public school divisions
Executive Order 55 signed November 4, 2025; a Department of Education task force is building the rolloutVirginia already belongs to the nurse, EMS, psychology and physician assistant licensure compacts.
Years 2 to 5
$40B
Future awards depend on progress
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.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
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.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading Virginia's spending data
Use the numbers in Virginia's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as Virginia reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search Virginia's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major Virginia announcements
Virginia's SNAP restriction takes effect, ending SNAP purchases of soda and other sweetened carbonated drinks.
Five regional Mobile and Hybrid Care RFAs open through planning district commissions, with applications due November 23, 2026.
The Virginia Health Care Foundation reports 25 RHT technology grants totaling $14.39 million for network upgrades, EHR modernization, cybersecurity and data exchange.
Virginia and CMS announce more than $122 million for ten partner organizations, which award competitive grants to rural health systems, clinics, schools and community groups.
CMS awards Virginia $189,544,888 for Year 1 of the Rural Health Transformation Program.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Aug 28, 2026$122 million in partner awards announced
- Oct 30, 2026Budget Period 1 ends
- Nov 1, 2026SNAP sweetened drink restriction takes effect
- Nov 23, 2026Regional Mobile and Hybrid Care RFAs close
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Jul 1, 2027Presidential Fitness Test deadline
- Jan 1, 2028Nutrition education requirement for physicians begins
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Remote patient monitoring, rural residency slots and the Virginia Health Care Foundation's interoperability and productivity grants are the main hospital lanes, and the foundation's first 25 grants went largely to EHR, network and cybersecurity upgrades. The five regional Mobile and Hybrid Care RFAs, open until November 23, 2026, are the next big round.
For partners and vendors
Virginia routes nearly all of its funding through ten key implementation partners, which run their own RFAs, so the way in is through those partners and the providers they fund. Early-stage health tech companies can apply to the Tech Innovation Fund run by the Virginia Innovation Partnership Corporation.
For applicants and grantees
Build tracking for the metrics Virginia reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Virginia's annual rescoring.
FAQ
Virginia RHTP FAQs
Who runs Virginia's Rural Health Transformation Program?
The Virginia Department of Medical Assistance Services (DMAS) runs Virginia's Rural Health Transformation Program, under the oversight of the Secretary of Health and Human Resources and using federal funding from the Centers for Medicare & Medicaid Services (CMS). DMAS manages the state's plan and works through key implementation partners, such as the Virginia Department of Health and the Virginia Hospital and Healthcare Association Foundation, that post the funding opportunities, and it takes questions through the contact form on the Virginia RHT site. The program is Virginia's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Virginia receive?
Virginia received $189,544,888 for Year 1 of the Rural Health Transformation Program, 37th of 50 states. Every state got $100 million in baseline funding, and the rest of Virginia's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Virginia's progress.
Can Virginia RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Virginia's award each year, about $37.9 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can Virginia providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to Virginia's plan, up to 15% of the award each year, about $28.4 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Virginia is spending its RHTP funding?
The RHTP Year One Report tracks how much of Virginia'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. Grants that partners awarded after July 31, such as the Virginia Health Care Foundation's 25 technology grants in October 2026, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Virginia
These RHT Alliance members serve Virginia providers, with support that spans EHR and billing, virtual nursing, virtual care, telehealth workflow, 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.
ViTel NetWorkflow platform for hub-and-spoke telehealth programs.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow Virginia's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.