Allotments

(A) In general For each of fiscal years 2026 through 2030, the Administrator shall determine under subparagraph (B) the amount of the allotment for such fiscal year for each State with an approved application under this subsection.

(B) Amount determined Subject to subparagraph (C), from the amounts appropriated under paragraph (1)(A) for each of fiscal years 2026 through 2030, the Administrator shall allot— (i) 50 percent of the amounts appropriated for each such fiscal year equally among all States with an approved application under this subsection; and (ii) 50 percent of the amounts appropriated for each such fiscal year among all such States in an amount to be determined by the Administrator in accordance with subparagraph (C).

(C) Requirements In determining the amount to be allotted to a State under clause (ii) of subparagraph (B) for a fiscal year, the Administrator shall— (i) ensure that not less than ¼ of the States with an approved application under this subsection for a fiscal year are allotted funds from amounts that are to be allotted under clause (ii) of such subparagraph; and (ii) consider— (I) the percentage of the State population that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)); (II) the proportion of rural health facilities (as defined in subparagraph (D)) in the State relative to the number of rural health facilities nationwide; (III) the situation of hospitals in the State, as described in section 1396a(a)(13)(A)(iv) of this title ; and (IV) any other factors that the Administrator determines appropriate.

(D) Rural health facility defined For the purposes of subparagraph (C)(ii), the term “rural health facility” means the following: (i) A subsection (d) hospital (as defined in paragraph (1)(B) of section 1395ww(d) of this title ) that— (I) is located in a rural area (as defined in paragraph (2)(D) of such section 6 6 So in original. Probably should be “subsection”. ); (II) is treated as being located in a rural area pursuant to paragraph (8)(E) of such section 6 ; or (III) is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)). (ii) A critical access hospital (as defined in section 1395x(mm)(1) of this title ). (iii) A sole community hospital (as defined in section 1395ww(d)(5)(D)(iii) of this title ). (iv) A Medicare-dependent, small rural hospital (as defined in section 1395ww(d)(5)(G)(iv) of this title ). (v) A low-volume hospital (as defined in section 1395ww(d)(12)(C) of this title ). (vi) A rural emergency hospital (as defined in section 1395x(kkk)(2) of this title ). (vii) A rural health clinic (as defined in section 1395x(aa)(2) of this title ). (viii) A Federally qualified health center (as defined in section 1395x(aa)(4) of this title ). (ix) A community mental health center (as defined in section 1395x(ff)(3)(B) of this title ). (x) A health center that is receiving a grant under section 254b of this title . (xi) An opioid treatment program (as defined in section 1395x(jjj)(2) of this title ) that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)). (xii) A certified community behavioral health clinic (as defined in section 1396d(jj)(2) of this title ) that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)).