Eligible health care providers must also be located in rural areas. Public and non-profit rural health care providers are eligible for support for any telecommunications services employing transmission speeds of less than or equal to 1.54 Mbps. The 1996 Act requires that universal service funds be available on a technology neutral and telecommunications provider neutral basis. In addition, any public or non-profit health care provider that does not have toll free access to an Internet service provider is eligible for limited support for toll charges to reach the nearest Internet service provider. Universal service funds will cover distance charges for the telecommunications services described above.
Many telecommunications carriers charge a per-mile fee for their services.
These mileage charges make up the bulk of the difference between the telecommunications costs of rural health care providers and those of their urban counterparts. The amount of the cap was based on an estimate of what it would cost if every eligible health care provider obtained universal service support for T-1 service and for limited toll free access to an Internet service provider. A universal service administrator will be designated by the FCC to process requests for support. Health care providers will submit descriptions of services requested to the administrator, who will post them on a universal service website. Telecommunications carriers may then contact the health care providers whose descriptions of services were posted and may submit bids for the provision of the requested services.