Sec.  54.607   Determining the rural rate.

   (a) The rural rate shall be the average of the rates actually being charged
   to commercial customers, other than health care providers, for identical or
   similar services provided by the telecommunications carrier providing the
   service in the rural area in which the health care provider is located. The
   rates included in this average shall be for services provided over the same
   distance as the eligible service. The rates averaged to calculate the rural
   rate must not include any rates reduced by universal service support
   mechanisms. The “rural rate” shall be used as described in this subpart to
   determine the credit or reimbursement due to a telecommunications carrier
   that provides eligible telecommunications services to eligible health care
   providers.

   (b) If the telecommunications carrier serving the health care provider is
   not providing any identical or similar services in the rural area, then the
   rural rate shall be the average of the tariffed and other publicly available
   rates, not including any rates reduced by universal service programs,
   charged for the same or similar services in that rural area over the same
   distance as the eligible service by other carriers. If there are no tariffed
   or publicly available rates for such services in that rural area, or if the
   carrier reasonably determines that this method for calculating the rural
   rate is unfair, then the carrier shall submit for the state commission's
   approval, for intrastate rates, or the Commission's approval, for interstate
   rates, a cost-based rate for the provision of the service in the most
   economically efficient, reasonably available manner.

   (1) The carrier must provide, to the state commission, or intrastate rates,
   or to the Commission, for interstate rates, a justification of the proposed
   rural rate, including an itemization of the costs of providing the requested
   service.

   (2) The carrier must provide such information periodically thereafter as
   required, by the state commission for intrastate rates or the Commission for
   interstate rates. In doing so, the carrier must take into account
   anticipated and actual demand for telecommunications services by all
   customers who will use the facilities over which services are being provided
   to eligible health care providers.