Please note: All regulations pertaining to pricing, provider payment rates, and the Health Safety Net are now the responsibility of the Executive Office of Health and Human Services and can be found on their website. Related public hearings and administrative bulletins can also be found at www.mass.gov/eohhs/gov/laws-regs/hhs/regs.html. For your convenience, CHIA will continue to maintain direct links to this content during this transition.

If you experience any difficulty finding the information you are looking for, please contact us at CHIA-Regulations@state.ma.us.


Public Comment
Public Hearings
Email Notifications
Regulations


 
Public Comments

Links to Public Comment Notice
and Regulatory Information

Comment Deadline, Mailing Address

Submit Comment Online

All-Payer Claims Data Fee Schedule (114.5 CMR 22.00)
Notice of Public Comment Period: PDF pdf format of    AB-13-03-APCD-Fee-Schedule-Notice-Public-Comment.pdf  | Word docx format of    AB-13-03-APCD-Fee-Schedule-Notice-Public-Comment.doc
 

By 5:00 p.m. on Friday, May 17, 2013
Two Boylston Street, Boston, MA 02116
Comment
Standard Payments to Nursing Facilities - 101 CMR 206.00 (Currently promulgated as 114.2 CMR 6.00)Comment Period ClosedComment Period Closed

 


 
Public Hearings

Links to Public Hearing Notice
and Regulatory Information

Public Hearing Date, Time, and Location

Period to
Submit Written Comments

Health Care Claims, Case Mix and Charge Data Release Procedures
(957 CMR 5.00)

Friday, June 14, 2013, at 10:00 a.m.
Two Boylston Street, Boston, MA 02116
By 5:00 p.m. on Monday, June 24, 2013
Register to Testify
Uniform Provider Reporting of the Standard Quality Measure Set
(957 CMR 4.00)
Wednesday, April 10, 2013 at 10:00 a.m.
Two Boylston Street, Boston, MA 02116
Comment period had ended
 
Assessment on Certain Health Care Providers & Surcharge Payors 
(957 CMR 3.00)
Wednesday, March 27, 2013 at 10:00 a.m.
Two Boylston Street, Boston, MA 02116
Comment period had ended
Payer Data Reporting
(957 CMR 2.00)
Friday, March 22, 2013 at 10:00 a.m.
Two Boylston Street, Boston, MA 02116
Comment period had ended

If you would like to testify at an upcoming public hearing, you may either sign up online or during the hearing.

You may also submit written testimony about proposed regulations by the specified date by emailing CHIA-Regulations@state.ma.us. Please submit electronic testimony as an attached Word document or as text within the body of the email and type the name of the regulation in the subject line. All submissions must include the sender's full name and address. Persons who are unable to submit electronic testimony should mail written testimony to the Center for Health Information and Analysis, Two Boylston Street, Boston, MA 02116-4704.

 

Email Notifications

You may sign up to receive email notifications about CHIA regulatory actions. There are four categories of regulations for which you may sign up to receive notifications through CHIA: Provider Payment Rates; Data Collection and Disclosure; Programs (Health Safety Net and Student Health); and Surcharges and Assessments.*

Please fill out this form in order to be added to the notification list.

You will receive an email notification whenever CHIA proposes a regulation, schedules a public hearing, adopts a regulation, or issues an administrative bulletin for any of the regulations in the category for which you signed up.

*Provider Payment Rates, the Health Safety Net, and Student Health are now maintained by the Executive Office of Health and Human Services and will eventually be responsible for these mailing lists.
 


 

Regulations

Regulations are listed in:
- Alphabetical Order (by name and service type)
- Numerical Order (by CMR number)

Regulations that appear below and within other CHIA web content are provided for informational use only. In the case of any discrepancy between versions within CHIA web content and the official Code of Massachusetts regulation published by the Secretary of State, the Secretary of State's version takes precedence. The effective dates of all regulations, informational bulletins, or other related documents are located in parentheses.

Note: Regulations highlighted in blue or marked with an asterisk (*) in this section will remain under the authority of CHIA.
 

Alphabetical Order (by name and service type)

 

 

Provider Payment Rates
(by provider type)

Community Health Care Providers (Ambulatory Care) 

Abortion and Sterilization Services Provided by Freestanding Clinics (114.3 CMR 13.00)
Acquired Brain Injury Waiver and Related Services (114.3 CMR 54.00)
Adult Day Health Services (114.3 CMR 10.00)
Adult Foster Care (114.3 CMR 51.00)
Ambulance Services (114.3 CMR 27.00)
Certain Children's Behavioral Health Services(114.3 CMR 52.00)
Chiropractic Services (114.3 CMR 28.00)
Chronic Maintenance Dialysis and Home Supplies (114.3 CMR 37.00)
Clinical Laboratory Services (114.3 CMR 20.00)
Community Health Centers (114.3 CMR 4.00)
Day Habilitation Program Services (114.3 CMR 48.00)
Dental Services (114.3 CMR 14.00)
Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment (114.3 CMR 22.00)
Early Intervention Program Services (114.3 CMR 49.00)
Family Planning Services (114.3 CMR 12.00)
Freestanding Ambulatory Surgical Facilities (114.3 CMR 47.00)
Free-Standing Birth Centers (114.3 CMR 55.00)
Hearing Aid Dispensers (114.3 CMR 23.00)
Home Health Services (114.3 CMR 50.00)
Hospice Services (114.3 CMR 43.00)
Independent Living Services for the Personal Care Attendant Program (114.3 CMR 9.00)
Medicine (114.3 CMR 17.00)
Mental Health Services Provided in Community Health and Mental Health Centers (114.3 CMR 6.00)
Outpatient Tuberculosis Control Services (114.3 CMR 8.00)
Prescribed Drugs (114.3 CMR 31.00)
Primary Care Clinician Plan Services Including Pay for Performance Program (114.3 CMR 53.00)
Prostheses, Prosthetic Devices, and Orthotic Devices (114.3 CMR 34.00)
Psychological Services (114.3 CMR 29.00)
Psychiatric Day Treatment (114.3 CMR 7.00)
Radiology (114.3 CMR 18.00)
Rehabilitation Centers, Audiological Services, and Restorative Services (114.3 CMR 39.00)
Substance Abuse Programs (114.3 CMR 46.00)
Surgery and Anesthesia (114.3 CMR 16.00)
TEAM Evaluation Services (114.3 CMR 30.00)
Temporary Nursing Services (114.3 CMR 45.00)
Vision Care Services and Ophthalmic Materials (114.3 CMR 15.00)
Worker's Compensation (ambulatory care services to industrial accident patients) (114.3 CMR 40.00)

Hospitals / Nursing Homes and Rest Homes

Hospital Services Provided to Industrial Accident Patients (114.1 CMR 41.00)
Rate and Charge Determination for Certain Intermediate Care Facilities Operated by the Department of Developmental Services (114.1 CMR 29.00)
Nursing Facilities (114.2 CMR 6.00)
Resident Care Facilities (114.2 CMR 4.00)

Purchase of Service: Rates for Social Services 

Certain Elder Care Services (114.4 CMR 17.00)
Rates for Clubhouse Services (114.4 CMR 16.00)
Competitive Integrated Employment Services (114.4 CMR 10.00)
Community Based Day Support Services (114.4 CMR 15.00)
Family Stabilization Services (114.4 CMR 14.00)
Family Transitional Support Services (114.4 CMR 12.00)
Placement and Support Services (114.4 CMR 11.00)
Social, Rehabilitation, and Health Care Services (114.5 CMR 4.00)
Supported Employment Services (114.4 CMR 19.00)
Youth Intermediate-Term Stabilization Services (114.4 CMR 13.00)
Youth Short-Term Stabilization and Emergency Placement Services (114.4 CMR 18.00)

Data Collection and Disclosure 

Payer Data Reporting (957 CMR 2.00) *
Criteria and Procedures for Submission of Health Plan Data (114.5 CMR 11.00) *
Disclosure of Hospital Case Mix and Charge Data (114.5 CMR 2.00) *
Health Care Claims Data Release (114.5 CMR 22.00) *
Health Care Claims Data Submission (114.5 CMR 21.00) *
Health Insurance Responsibility Disclosure (HIRD Forms and other information) (114.5 CMR 18.00)
Hospital Financial Reports (114.1 CMR 42.00) *
Payer Reporting of Total Medical Expenses and Relative Prices (114.5 CMR 23.00) *
Requirement for Submission of Hospital Case Mix and Charge Data (114.1 CMR 17.00) *

Programs 

Health Safety Net Eligible Services (114.6 CMR 13.00)
Health Safety Net Payments and Funding (includes surcharge on hospital payments) (114.6 CMR 14)
Student Health Insurance (114.6 CMR 3.00)

Surcharges and Assessments

Employer Fair Share Contribution (114.5 CMR 16.00)
Employer Surcharge for State-Funded Health Costs (114.5 CMR 17.00)
Health Safety Net Payments and Funding (includes provider payments) (114.6 CMR 14)
Nursing Facility User Fee(114.5 CMR 12.00)
Pediatric Immunization Program Assessment (114.5 CMR 20.00)
 
* Remaining under the authority of CHIA.

 
 


Numerical Order (by CMR number)

Please note: This table only includes information pertaining to regulations still under the authority of CHIA. For a comprehensive list of regulations once maintained by DHCFP, please see the previous section, which includes links to the appropriate portion of the Executive Office of Health and Human Services' regulations page.
 

Regulation Name
(Effective Date)

Format

 
114.1 CMR 17.00

Requirement for the Submission of Hospital Case Mix and Charge Data
(October 1, 2006)
PDF pdf format of    114-1-17.pdf  Word doc format of    114-1-17.doc
Administrative Bulletin:
Reporting Format for the Physicians' National Provider Identifier (NPI)
(May 13, 2011)
PDF pdf format of    1111.pdf  Word doc format of    1111.doc

Administrative Bulletin:
Requirement for the Submission of Hospital Case Mix and Charge Data
(March, 18 2010)

PDF pdf format of    1006.pdf  Word doc format of    1006.doc
Nursing and Rest Home Facility List PDF pdf format of    nursing-and-rest-home-facility-list.pdf  Excel xls format of    nursing-and-rest-home-facility-list.xls
Update for Present on Admission
(November 19, 2007)
PDF pdf format of    114-1-17-poa-letter.pdf  Word doc format of    114-1-17-poa-letter.doc
Case Mix Submissions- FAQ
(February 2, 2007)
PDF pdf format of    114-1-17-faq.pdf  Word doc format of    114-1-17-faq.doc
Submission Update
(December 19, 2006)
PDF pdf format of    114-1-17-spec-update.pdf  Word doc format of    114-1-17-spec-update.doc
Data Specifications:--------
Hospital Inpatient Discharge: Data Specifications
(May 2011)
PDF pdf format of    114-1-17-inpatient-specs.pdf  Word doc format of    114-1-17-inpatient-specs.doc  file size 1MB
Hospital Emergency Department: Data Specifications
(December 2010)
PDF pdf format of    114-1-17-ed-data-specs.pdf  Word doc format of    114-1-17-ed-data-specs.doc  file size 1MB
Hospital Emergency Department: Summary of Changes
(June 2006)
PDF pdf format of    114-1-17-ed-summary-changes.pdf  Word doc format of    114-1-17-ed-summary-changes.doc
Hospital Outpatient Observation: Data Specifications
(September 2006)
PDF pdf format of    114-1-17-ooa-data-specs.pdf  Word doc format of    114-1-17-ooa-data-specs.doc
Hospital Outpatient Observation: Summary of Changes
(June 2006)
PDF pdf format of    114-1-17-ooa-summary-changes.pdf  Word doc format of    114-1-17-ooa-summary-changes.doc
Previous Information/Submission Updates:--------
Informational Update to Hospital Inpatient Discharge: Payer Codes for FY10 Filing
(October 2009)
PDF pdf format of    114-1-17-payer-source-codes-2010.pdf  Word doc format of    114-1-17-payer-source-codes-2010.doc
Hospital Inpatient Discharge: Data Specifications
(October 2008)
PDF pdf format of    114-1-17-inpatient-specs-2008.pdf  Word doc format of    114-1-17-inpatient-specs-2008.doc  file size 1MB
Hospital Inpatient Discharge: Data Specifications
(September 2006)
PDF pdf format of    114-1-17-hdd-data-specs.pdf  Word doc format of    114-1-17-hdd-data-specs.doc  file size 1MB
Hospital Inpatient Discharge: Summary of Changes
(June 2006)
PDF pdf format of    114-1-17-hdd-summary-changes.pdf  Word doc format of    114-1-17-hdd-summary-changes.doc
Submission Update
(September 14, 2006)
PDF pdf format of    114-1-17-submission-update.pdf  Word doc format of    114-1-17-submission-update.doc
Hierarchy for Mapping Ethnicity
(September 14, 2006)
PDF pdf format of    114-1-17-hierarchy-ethnicity.pdf  Word doc format of    114-1-17-hierarchy-ethnicity.doc
Summary of Adopted Changes
(July 20, 2006)
PDF pdf format of    114-1-17-summary.pdf  Word doc format of    114-1-17-summary.doc
Summary of Proposed Changes
(May 11, 2006)
PDF pdf format of    114-1-17-p-summary.pdf  Word doc format of    114-1-17-p-summary.doc

 
114.1 CMR 42.00

Notice of Public Hearing
- Friday, June 22, 2012 at 10:00 AM
PDF pdf format of    114-1-42-nph.pdf  Word doc format of    114-1-42-nph.doc
Proposed Regulation
Hospital Financial Reports
(August 1, 2012)
PDF pdf format of    114-1-42-p.pdf  Word doc format of    114-1-42-p.doc
Hospital Financial Reports
(February 15, 2011)
PDF pdf format of    114-1-42.pdf  Word doc format of    114-1-42.doc
Administrative Bulletin 12-02:
- Hospital Licensed Health Center Cost Reports
(January 13, 2012)
PDF pdf format of    12-02.pdf  Word doc format of    12-02.doc
Administrative Bulletin 11-17
- Regarding hospital reporting of bad debt
(December 15, 2011)
PDF pdf format of    1117.pdf  Word doc format of    1117.doc
Administrative Bulletin:
FY2010 Hospital Licensed Health Center Cost Reports
PDF pdf format of    1109.pdf  Word doc format of    1109.doc
Link to DHCFP-INET Online Reporting System Information--------
Link to Nursing Facility Reports--------

 
114.5 CMR 2.00

Disclosure of Hospital Case Mix and Charge Data
(July 20, 2009)
PDF pdf format of    114-5-2.pdf  Word doc format of    114-5-2.doc

 
114.5 CMR 11.00

Criteria and Procedures for The Submission of
Health Plan Data
(April 8, 2005)
PDF pdf format of    114-5-11.pdf  Word doc format of    114-5-11.doc

 
114.5 CMR 16.00

Determination of the Employer Fair Share Contribution
(October 1, 2009)
PDF pdf format of    114-5-16.pdf  Word doc format of    114-5-16.doc
Executive Office of Labor and Workforce Development, includes an update on the Fair Share Contribution (FSC) Program and further information on and how it impacts employers.

 
114.5 CMR 17.00

Employer Surcharge for State-funded Health Costs
(July 1, 2007)
PDF pdf format of    114-5-17.pdf  Word doc format of    114-5-17.doc

 
114.5 CMR 18.00

Health Insurance Responsibility Disclosure (HIRD)
(April 1, 2009)
PDF pdf format of    114-5-18.pdf  Word doc format of    114-5-18.doc
HIRD Forms and Information

 
114.5 CMR 21.00

Administrative Bulletin 13-04:
Health Care Payers Claims Data Submission - Changes to Guidelines
(May 9, 2013)
PDF pdf format of    13-04-AB-Payer-Data-Submission.pdf  Word docx format of    13-04-AB-Payer-Data-Submission.doc

Administrative Bulletin 13-02:
Health Care Payers Claims Data Submission - Changes to Guidelines
(April 5, 2013)

PDF pdf format of    AB-13-02_Payers-Claims-Data-Submissions_114-5-CMR-21-00  Word docx format of    AB-13-02_Payers-Claims-Data-Submissions_114-5-CMR-21-00
Total Medical Expenses Reporting in APCD Update
(February 2013)
PDF pdf format of    APCD TME Carrier Memo General Final 130205.pdf  Word docx format of    APCD TME Carrier Memo General Final 130205.doc
Question and Answer Document
(January 31, 2013) - This document will be routinely updated
  Excel xlsx format of    MA_APCD_Admin_Bull_QA_20130131.xls
Administrative Bulletin:
Health Care Payers Claims Data Submission - Changes to Guidelines
(November 8, 2012)
PDF pdf format of    Administrative Bulletin - 12-01 - APCD  Word docx format of    957-2_00-payer-data-emergency-adopted-reg.doc
New Element Submission Guideline
(November 8, 2012)
PDF * Excel xls format of    APCD Administrative Bulletin Element Update 2012-11-16.
Administrative Bulletin:
Health Care Payers Claims Data Submission
PDF pdf format of    1105.pdf  Word doc format of    1105.doc

Administrative Bulletin:
Health Care Claims Data Submission - claims data reporting requirements

PDF pdf format of    1015.pdf  Word doc format of    1015.doc

Administrative Bulletin:
Health Care Claims Data Submission

PDF pdf format of    1014.pdf  Word doc format of    1014.doc
Health Care Claims Data Submission
(July 23, 2010)
PDF pdf format of    114-5-21.pdf  Word doc format of    114-5-21.doc

 
114.5 CMR 22.00

Administrative Bulletin 13-03
APCD Data Fee Schedule
(Effective July 1, 2013)
PDF pdf format of    AB-13-03-APCD-Fee-Schedule.pdf  Word docx format of    AB-13-03-APCD-Fee-Schedule.doc
Notice of Public Hearing
Monday, November 19, 2012
(See Public Hearing Comments)
PDF pdf format of    114-5-22-nph-2012.pdf  Word doc format of    114-5-22-nph-2012.doc
Administrative Bulletin 12-31
Data Fee Schedule
(October 5, 2012)
PDF pdf format of    apcd-ab-fee-schedule-10-5-12.pdf  Word doc format of    apcd-ab-fee-schedule-10-5-12.doc
Notice of Public Hearing
Monday, May 17, 2010
(See Public Hearing Comments)
PDF pdf format of    114-5-22-nph.pdf  Word doc format of    114-5-22-nph.doc
Health Care Claims Data Release
(July 23, 2010)
PDF pdf format of    114-5-22.pdf  Word doc format of    114-5-22.doc
Administrative Bulletin 12-15
Reclassification of Certain Data Elements
(May 24, 2012)
PDF pdf format of    1215.pdf  Word doc format of    1215.doc
Administrative Bulletin 12-14
Administrative Procedures and Guidelines
(May 24, 2012)
PDF pdf format of    1214.pdf  Word doc format of    1214.doc

 
114.5 CMR 23.00

Payer Reporting of Total Medical Expenses and Relative Prices
(effective April 1, 2011)  
PDF pdf format of    114-5-23.pdf  Word doc format of    114-5-23.doc
Additional information and materials regarding Total Medical Expenses and Relative Pricing----
Link to DHCFP-INET Online Reporting System Information----

 
114.6 CMR 3.00

Student Health Insurance
(June 1, 2009)
PDF pdf format of    114-6-3.pdf  Word doc format of    114-6-3.doc
Administrative Bulletin:
Consolidated Filings
(March 2011)
PDF pdf format of    1108.pdf  Word doc format of    1108.doc
Administrative Bulletin:
Mandatory Health Insurance Coverage
(July 2009)
PDF pdf format of    0912.pdf  Word doc format of    0912.doc
Outline of Changes to Student Health Insurance Regulation PPT ppt format of    114-6-3-outline-of-changes.ppt  Word doc format of    114-6-3-outline-of-changes.doc

 
957 CMR 2.00

Notice of Public Hearing
Friday, March 22, 2013
  PDF pdf format of    957-2_00-notice-of-public-hearing-3-22-13.pdf  Word docx format of    957-2_00-payer-data-emergency-adopted-reg.doc
Payer Data Reporting
(February 5, 2013)
  PDF pdf format of    957-2_00-payer-data-emergency-adopted-reg.pdf  Word docx format of    957-2_00-payer-data-emergency-adopted-reg.doc

 
957 CMR 3.00

Notice of Public Hearing
Wednesday, March 27, 2013
PDF pdf format of    957_3-00-CHIA-Assessment-PHN-2013-03-13.pdf  Word docx format of    957_3-00-CHIA-Assessment-PHN-2013-03-13.doc
Assessment on Certain Health Care Providers & Surcharge Payors
(February 19, 2013)
PDF pdf format of    957_3-00-CHIA-Assessment-Regulation.pdf  Word docx format of    957_3-00-CHIA-Assessment-Regulation.doc

 
957 CMR 4.00

Notice of Public Hearing
Wednesday, April 10, 2013
PDF pdf format of    957_CMR-4_00-Quality-Measure-Set_Hearing-Notice.pdf  Word docx format of    957_CMR-4_00-Quality-Measure-Set_Hearing-Notice.doc
Uniform Provider Reporting of the Standard Quality Measure Set
(March 1, 2013)
PDF pdf format of    957_CMR-4_00-Quality-Measure-Set_Regulation.pdf  Word docx format of    957_CMR-4_00-Quality-Measure-Set_Regulation.doc

 
957 CMR 5.00

Notice of Public Hearing
Friday, June 14, 2013
PDF pdf format of    957-5_00-Data-Release-NPH.pdf  Word docx format of    957-5_00-Data-Release-NPH.doc

Health Care Claims, Case Mix and Charge Data Release Procedures
(May 9, 2013)

PDF pdf format of    957_5_00-data-release-proposed-reg.pdf  Word docx format of    957_5_00-data-release-proposed-reg.doc