As 2026 begins, healthcare stakeholders face a convergence of critical developments. A potential federal government shutdown looms at the end of January, threatening continuity in programs that impact patients, providers, and telehealth access nationwide.
At the same time, the U.S. Department of Health and Human Services (HHS) has begun disbursing funds from the Rural Health Transformation Program, bringing unprecedented investment to strengthen care in rural communities, with Texas among the largest recipients. Across the states, legislative sessions are now underway, with policymakers focused on healthcare workforce expansion, interstate licensing compacts, telehealth policy, and other initiatives that will shape access and delivery for the year ahead.
Federal Activity
Racing Against the Clock: January 30th Deadline
Last year, Congress temporarily restored government operations and telehealth flexibilities following a 43-day shutdown by passing a continuing resolution (CR) that extended funding through January 30, 2026. As of today, lawmakers have not finalized full-year appropriations bills or passed an additional funding extension, raising renewed concerns about the risk of another government shutdown.
Significant funding disputes remain unresolved, including Department of Homeland Security (DHS) appropriations and several policy riders. With only a few weeks remaining before the January 30 deadline, Congress faces mounting pressure to reach an agreement and ensure continuity of government operations. Critical health services, including telehealth programs and key waivers such as Acute Hospital Care at Home, which allows certain hospital-level care to be delivered in patients’ homes, are tied to the same funding timeline. Without congressional action, these programs could lapse, creating administrative and coverage uncertainty for providers and potentially impacting the health and well-being of millions of Americans.
Rural Transformation Fund: State Allocations and Next Steps
Last year, Congress enacted the One Big Beautiful Bill, which established the Rural Transformation Fund, a $50 billion, multi-year investment designed to modernize and strengthen rural health systems nationwide. All 50 states submitted applications for funding consideration.
On December 29, the HHS announced the release of the first $10 billion in annual funding. Each state is receiving a base allocation, with additional funding awarded to states that committed to priority reforms, including expanding interstate licensure compacts, strengthening nutrition education, modernizing Supplemental Nutrition Assistance Program (SNAP) waivers, and advancing strategic partnerships between rural hospitals and larger health systems.
Texas was the largest recipient nationally, receiving approximately $281 million. This reflects both the significant rural health care needs across the state and Texas’ participation in priority access and workforce initiatives. By comparison, state awards range from approximately $147 million to more than $280 million, with a national average of roughly $200 million per state. The list of awards is here: https://www.cms.gov/newsroom/press-releases/cms-announces-50-billion-awards-strengthen-rural-health-all-50-states
The individual states will now begin the process to determine how these funds will be allocated to support rural health system modernization, including modernization of IT infrastructure, workforce development, and access to care initiatives.
DEA Telemedicine Flexibilities: Policy Update
Earlier this month, HHS confirmed that the Drug Enforcement Administration (DEA) temporary telemedicine flexibilities for prescribing controlled substances will remain in effect through December 31, 2026. Under this policy, patients can continue to access Schedule II through Schedule V medications via telehealth without an in-person visit.
Compliance in the Face of Rising Fraud
Recent allegations of fraudulent activity have placed a national spotlight on the critical need for rigorous workforce oversight. As of January 2026, federal and state authorities have intensified investigations into alleged Medicaid fraud, and the Trump Administration announced the creation of a new Department of Justice Division for National Fraud Enforcement on January 8, 2026, to combat widespread fraud.
2026 State Legislative Update: Key Developments
In 2026, 46 state legislatures will convene to address a wide range of issues, including but not limited to workforce, artificial intelligence (AI), new professional licensure categories, and state-mandated continuing education (CE) requirements. Our team is actively tracking hundreds of bills nationwide. Below are a few notable activities since our last update:
Continuing Education and Required Tracking
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Menopause CME (New Jersey): A-5309, enacted through a veto override on December 18, 2025, requires the Board of Medical Examiners and the Board of Nursing to allow physicians and APRNs to earn up to three optional CME credits focused on menopause.
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Electronic CE tracking system (New Jersey): Senate (S)4387 signed by the Governor on January 20, 2026, mandates the New Jersey Department of Community Affairs (DCA) to implement an electronic system to track continuing education for all licensed professions. The system ensures CE compliance prior to license renewal and has received support from the NJ Nurses Association, NJ Chamber of Commerce, Business & Industry Association, and other stakeholders.
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Congenital CMV CE (Florida): House Bill (HB) 1203, introduced January 8, 2026, would require physicians, nurses, and midwives to complete a one-hour, board-approved course on congenital cytomegalovirus (CMV) as part of initial licensure and every other license renewal, starting July 1, 2026.
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Sickle cell disease CE (Florida): Senate Bill (SB) 844 requires medical, nursing, and certain other healthcare boards to mandate a two-hour continuing education course on sickle cell disease care management as part of the first licensure or certification renewal.
Other State Legislative Developments
Nursing titles clarification (Washington): SB5904 / HB2155 amend Washington state law governing the use of nursing titles and practice. Only individuals properly licensed under the relevant chapters or holding a valid multistate license may use titles and abbreviations associated with R.N., A.R.N.P. / A.P.R.N., N.P., and L.P.N.
Telehealth registration (Wisconsin): SB214 allows out-of-state healthcare providers to offer telehealth services in Wisconsin by registering with the Department of Safety and Professional Services (DSPS) or an appropriate credentialing board. Providers must hold an active, unencumbered credential in another state, have no disciplinary actions in the past five years, designate a service agent in Wisconsin, and maintain malpractice insurance. Registered providers cannot open physical offices or deliver in-person care without obtaining a Wisconsin credential. DSPS will publish a list of registered providers and their credentials online. The bill also establishes disciplinary actions, including suspension or revocation, for non-compliance, and takes effect on the first day of the seventh month after publication.
Responsible artificial intelligence governance (New Hampshire): HB1725 creates a new chapter in New Hampshire law to regulate the development, deployment, and use of artificial intelligence (AI) technologies. The bill applies to all individuals, businesses, and government entities operating in the state or providing products or services to its residents. It establishes the New Hampshire Artificial Intelligence Council, a seven-member advisory body with expertise in AI, ethics, data privacy, or public policy, which will provide guidance on ethical AI practices and report annually to the governor and legislature. The bill requires clear consumer disclosure when interacting with AI.
Professional licensing: Limits on disclosure of past events (Mississippi): HB319 restricts the information state licensing boards that state licensing authorities can require individuals to disclose when applying for professional licenses. Specifically, the bill prohibits disclosure of: arrests not resulting in convictions; convictions that have been expunged or overturned; nonviolent misdemeanors; or convictions more than three years old without incarceration (or if incarceration ended more than three years ago). Exceptions apply to felony convictions related to violent crimes or fraud.
Stay Ahead With Us
As legislative sessions move forward and new mandates take shape, staying compliant shouldn’t be a moving target. At Propelus®, we believe that tracking policy is about spotting the trends that will redefine healthcare delivery.
The regulatory landscape is a leading indicator of our industry’s future. By monitoring these shifts in real-time, we help you stay ahead of the curve, transforming emerging policy trends into a competitive advantage. Our technology is designed to turn complex state requirements, like the electronic tracking mandates in New Jersey, into seamless, automated workflows before they take effect.
Through Propelus CE Broker®, we provide the vital infrastructure that connects boards, professionals, and employers in a single, secure ecosystem. In an evolving 2026 landscape, you need a partner who doesn’t just react to change, but anticipates it. We are dedicated to ensuring your workforce is not just qualified and compliant, but strategically positioned for whatever comes next.
Learn more about how CE Broker supports state boards.