Sec. 54.613   Limitations on supported services for rural health care 
          providers.

    (a) Upon submitting a bona fide request to a telecommunications 
carrier, each eligible rural health care provider is entitled to receive 
the most cost-effective, commercially-available telecommunications 
service using a bandwidth capacity of 1.544 Mbps, at a rate no higher 
than the highest urban rate, as defined in this subpart, at a distance 
not to exceed the distance between the eligible health care provider's 
site and the farthest point from that site that is on the jurisdictional 
boundary of the nearest large city, as defined in Sec. 54.605(c).
    (b) The rural health care provider may substitute any other service 
or combination of services with transmission capacities of less than 
1.544 Mbps transmitted over the same or a shorter distances, so long as 
the total annual support amount for all such services combined, 
calculated as provided in this subpart, does not exceed what the support 
amount would have been for the service described in paragraph (a) of 
this section. If the rural health care provider is located in an area 
where a service using a bandwidth capacity of 1.544 Mbps is not 
available,

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then the total annual support amount for that provider shall not exceed 
what the support amount would have been under paragraph (a) of this 
section, calculated using the rural rate for a service of that capacity 
in another area of the state.
    (c) This section shall not affect a rural health care provider's 
ability to obtain supported services under Sec. 54.621.