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

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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.