Regulations


CHIA Regulations

 

Administrative Bulletins
Public Hearings and Comments

CHIA Regulations in Alphabetical Order

Regulation
Description
CMR Reference
APCD and Case Mix Data Submission This regulation governs the reporting requirements regarding health care data and information that health care Payers and Hospitals must submit in connection with the All Payer Claims Database (APCD) and the Acute Hospital Case Mix and Charge Data (Case Mix and Charge) Databases.  
This regulation governs payments to the Center for Health Information and Analysis from certain Acute Hospitals, Ambulatory Surgical Centers and Surcharge Payors.
This regulation governs the filing requirements for certain providers to report their costs and other data to the Center for Health Information and Analysis.
This regulation establishes the data and information that every health insurance plan in the Commonwealth must provide to be used to create the health plan report card required by M.G.L. c. 118G, § 24. 114.5 CMR 11.00.
This regulation governs the reporting requirements for Health Care Payers to submit data and information.
This regulation governs the disclosure of certain payer data, hospital case mix data and hospital charge data submitted by health care payers and providers pursuant to M.G.L. c. 12C. The purpose of 957 CMR 5.00 is to specify (a) the process by which data will be released to certain requesters as required by M.G.L. c. 12C; and (b) the application and data release process for all other requests for certain payer, hospital case mix and hospital charge data collected and maintained by the Center for Health Information and Analysis.
This regulation governs the financial reporting requirements for acute and non-acute hospitals, including annual cost reports, charge books, quarterly filing requirements, and the uniform reporting of inpatient and outpatient costs, including direct and indirect costs.
The regulation, effective July 4, 2014, sets forth the filing requirements, procedures and time frames for nursing facilities to report their costs and other data to the Center.
This regulation governs the methodology and filing requirements for health care payers to calculate and report Health Status Adjusted Total Medical Expenses, Relative Prices, and Alternative Payment Method information to the Center for Health Information and Analysis.
This regulation governs acute hospital Case Mix and Charge Data submission requirements. The Data contain information about each inpatient admission, outpatient observation stay and emergency department visit.
This regulation governs the establishment, use of, and uniform reporting requirements for certain health care provider performance measures included in the Standard Quality Measure Set.
 

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Numerical Order (by CMR number) 

Main regulations are highlighted, followed by additional relevant updates or materials.

114.1 CMR 17.00 - Requirement for the Submission of Hospital Case Mix and Charge Data
(effective October 1, 2006)
Administrative Bulletin 11-11
Reporting Format for the Physicians' National Provider Identifier (NPI)
(May 13, 2011)
Administrative Bulletin 10-06
Requirement for the Submission of Hospital Case Mix and Charge Data
(March, 18 2010)
Nursing and Rest Home Facility List    
Update for Present on Admission
(November 19, 2007)
Case Mix Submissions- FAQ
(February 2, 2007)
Submission Update
(December 19, 2006)
Data Specifications
Hospital Inpatient Discharge: Data Specifications
(April 2014)
Hospital Emergency Department: Data Specifications
(April 2014)
Hospital Outpatient Observation: Data Specifications
(April 2014)
Payer Codes
Hospital Inpatient Discharge: Data Specifications
(May 2011)
Hospital Emergency Department: Data Specifications
(December 2010)
Hospital Emergency Department: Summary of Changes
(June 2006)
Hospital Outpatient Observation: Data Specifications
(September 2006)
Hospital Outpatient Observation: Summary of Changes
(June 2006)
Previous Information/Submission Updates
Informational Update to Hospital Inpatient Discharge: Payer Codes for FY10 Filing
(October 2009)
Hospital Inpatient Discharge: Data Specifications
(October 2008)
Hospital Inpatient Discharge: Data Specifications
(September 2006)
Hospital Inpatient Discharge: Summary of Changes
(June 2006)
Submission Update
(September 14, 2006)
Hierarchy for Mapping Ethnicity
(September 14, 2006)
Summary of Adopted Changes
(July 20, 2006)
Summary of Proposed Changes
(May 11, 2006)
114.1 CMR 42.00 - Hospital Financial Reports
(effective February 15, 2011)
Administrative Bulletin 13-07
Acute Hospital Financial Reporting – Top 10 Compensated Employees
(October 25, 2013)
Administrative Bulletin 12-02
Hospital Licensed Health Center Cost Reports
(January 13, 2012)
Administrative Bulletin 11-17
Regarding hospital reporting of bad debt
(December 15, 2011)
Administrative Bulletin 11-09
FY2010 Hospital Licensed Health Center Cost Reports
114.5 CMR 11.00 - Criteria and Procedures for The Submission of Health Plan Data
(effective of April 8, 2005)
114.5 CMR 21.00 - Health Care Claims Data Submission
(effective of May 9, 2013)
Administrative Bulletin 13-02
Health Care Payers Claims Data Submission - Changes to Guidelines
(April 5, 2013)
Total Medical Expenses Reporting in APCD Update
(February 2013)
Question and Answer Document
(January 31, 2013) - This document will be routinely updated
Administrative Bulletin 12-01
Health Care Payers Claims Data Submission - Changes to Guidelines
(November 8, 2012)
New Element Submission Guideline
(November 8, 2012)
Administrative Bulletin11-05
Health Care Payers Claims Data Submission
Administrative Bulletin 10-15
Health Care Claims Data Submission - claims data reporting requirements
Administrative Bulletin 10-14
Health Care Claims Data Submission
Health Care Claims Data Submission
(July 23, 2010)
957 CMR 2.00 - Payer Data Reporting
(effective February 5, 2013)
Administrative Bulletin 14-02
Alternative Payment Methods Insurance Category Reporting
(Effective January 17, 2014)
Administrative Bulletin 14-03
Extended Filing Deadline for Collecting Certain Alternative Payment Methods Data and Network Average Relative Price Amounts
(Effective January 17, 2014)
957 CMR 3.00 - Assessment on Certain Health Care Providers & Surcharge Payers
(effective August 16, 2013)
957 CMR 4.00 - Uniform Provider Reporting of the Standard Quality Measure Set
(effective March 1, 2013)
Administrative Bulletin 14-09
Updates to the Uniform Provider Reporting of the Standard Quality Measure Set
(Effective November 7, 2014)
Administrative Bulletin 14-07
Uniform Provider Reporting of the Standard Quality Measure Set
(Effective May 15, 2014)
Administrative Bulletin 14-04
Uniform Provider Reporting of the Standard Quality Measure Set
(Effective February 20, 2014)
Administrative Bulletin 13-08
Uniform Provider Reporting of the Standard Quality Measure Set
(Effective October 25, 2013)
957 CMR 5.00 - Health Care Claims, Case Mix and Charge Data Release Procedures
(effective July 19, 2013)
Administrative Bulletin 14-01:
Health Care Claims, Case Mix and Charge Data Release Procedures
(Effective January 9, 2014)
Administrative Bulletin 13-11
All-Payer Claims Data Fee Schedule
(December 27, 2013)
Data Release Regulation: Comments and Responses
Administrative Bulletin 13-05
Health Care Claims Data and Reclassification of Data Elements
(Effective July 19, 2013)
Administrative Bulletin 13:06
Data Fee Schedule  
(Effective July 19, 2013)
Administrative Bulletin 13-09
Health Care Claims, Case Mix and Change Data Release.
(November 22, 2013)
957 CMR 6.00 - Cost Reporting Requirements
(effective April 25, 2014)
957 CMR 7.00 - Nursing Facilities Cost Reporting Requirements
(July 4, 2014)
957 CMR 8.00 - APCD and Case Mix Data Submission
(July 31, 2014)

Administrative Bulletin 14-08:
- Submission of new data elements
(Effective October 30, 2014)

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All Administrative Bulletins

CHIA administrative bulletins are listed in reverse chronological order by year.

2014
Administrative Bulletin 14-09:
Updates to the Uniform Provider Reporting of the Standard Quality Measure Set
(Effective November 7, 2014)
Related Regulation: 957 CMR 4.00: Uniform Provider Reporting of the Standard Quality Measure Set
Administrative Bulletin 14-08:
- Submission of new data elements
(Effective October 30, 2014)
Related Regulation: 957 CMR 8.00: APCD and Case Mix Data Submission
Administrative Bulletin 14-07: - Quality measures recommended by the Statewide Quality Advisory Committee (SQAC)
(Effective May 15, 2014)
Related Regulation: 957 CMR 4.00: Uniform Provider Reporting of the Standard Quality Measure Set
Administrative Bulletin 14-06: - Acute Hospital Financial Reporting – Top 10 Compensated Employees
(Effective April 11, 2014)
Related Regulation: 114.1 CMR 42.00: Hospital Financial Reports
Administrative Bulletin 14-05: - Anticipated transition from ICD-9 to ICD-10
(Effective April 11, 2014)
Related Regulation: 114.1 CMR 17.00: Requirement for the Submission of Hospital Case Mix and Charge Data
Administrative Bulletin 14-04:
Hospitals’ reporting requirements related to the Standard Quality Measure Set (SQMS) measures
(Effective February 20, 2014)
Related Regulation: 957 CMR 4.00: Uniform Provider Reporting of the Standard Quality Measure Set
Administrative Bulletin 14-03: - Extended Filing Deadline for Collecting Certain Alternative Payment Methods Data and Network Average Relative Price Amounts
(Effective January 17, 2014)
Related Regulation: 957 CMR 2.00: Payer Data Reporting
Administrative Bulletin 14-02: - Alternative Payment Methods Insurance Category Reporting
(Effective January 17, 2014)
Related Regulation: 957 CMR 2.00: Payer Data Reporting
Administrative Bulletin 14-01: - Health Care Claims, Case Mix and Charge Data Release Procedures
(Effective January 9, 2014)
Related Regulation: 957 CMR 5.00: Health Care Claims, Case Mix and Charge Data Release Procedures
2013
Administrative Bulletin 13-11: All-Payer Claims Data Fee Schedule
(December 27, 2013)
Related Regulation: 957 CMR 5:00: Health Care Claims, Case Mix and Charge Data Release Procedures
Administrative Bulletin 13-10: Nursing and Resident Care Facilities Extension of Cost Report Due Dates
(December 19, 2013)
Related Regulations: Nursing facility and resident care facility cost reports; See EOHHS Regulations regarding Hospitals/Nursing Homes and Rest Homes
Administrative Bulletin 13-09: Health Care Claims, Case Mix and Change Data Release.
(November 22, 2013)
Related Regulation:  957 CMR 5.00 - Health Care Claims, Case Mix and Change Data Release Procedure
Administrative Bulletin 13-08: Uniform Provider Reporting of the Standard Quality Measure Set
(October 25, 2013)
Related Regulation: 957 CMR 4.00 - Uniform Provider Reporting of the Standard Quality Measure Set
Administrative Bulletin 13-07: Acute Hospital Financial Reporting – Top 10 Compensated Employees
(October 25, 2013)
Related Regulation: 114.1 CMR 42.00 - Hospital Financial Reports
Administrative Bulletin 13:06: Data Fee Schedule  
(July 19, 2013)
Related Regulation(s): 957 CMR 5.00 - Health Care Claims, Case Mix and Charge Data Release Procedures and 114.5 CMR 22.00 - Health Care Claims Data Release
Administrative Bulletin 13-05: Health Care Claims Data and Reclassification of Data Elements
(July 19, 2013)
Related Regulation(s): 957 CMR 5.00 - Health Care Claims, Case Mix and Charge Data Release Procedures and 114.5 CMR 22.00 - Health Care Claims Data Release
Administrative Bulletin 13-04: Health Care Payers Claims Data Submission - Changes to Guidelines
(May 9, 2013)
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
Administrative Bulletin 13-03: APCD Data Fee Schedule
(July 1, 2013)
 
Administrative Bulletin 13-02: Health Care Payers Claims Data Submission - Changes to Guidelines
(April 5, 2013)
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
Administrative Bulletin 13-01: Extension of Cost Report Due Dates
(January 17, 2013)
Related Regulation(s) (EOHHS) : 114.2 CMR 4.00  Resident Care Facilities and 114.2 CMR 6.00  Standard Payments to Nursing Facilities
2012
Administrative Bulletin 12-31: Data Fee Schedule
(October 25, 2012)
 
Administrative Bulletin 12-15: Reclassification of Certain Data Elements
(May 24, 2012)
 
Administrative Bulletin 12-14: Administrative Procedures and Guidelines
(May 24, 2012)
 
Administrative Bulletin 12-02: Hospital Licensed Health Center Cost Reports
(January 13, 2012)
Related Regulation: 114.1 CMR 42.00 - Hospital Financial Reports
Administrative Bulletin 12-01: Health Care Payers Claims Data Submission - Changes to Guidelines
(November 8, 2012)
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
New Element Submission Guideline (for 12-01)
(November 8, 2012)
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
 
2011
Administrative Bulletin 11-17: Regarding hospital reporting of bad debt
(December 15, 2011)
Related Regulation: 114.1 CMR 42.00 - Hospital Financial Reports
Administrative Bulletin: 11-11: Reporting Format for the Physicians' National Provider Identifier (NPI)
(May 13, 2011)
Related Regulation: 114.1 CMR 17.00 - Requirement for the Submission of Hospital Case Mix and Charge Data
Administrative Bulletin 11-09: FY2010 Hospital Licensed Health Center Cost Reports
Related Regulation: 114.1 CMR 42.00 - Hospital Financial Reports
Administrative Bulletin 11-05: Health Care Payers Claims Data Submission
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
2010
Administrative Bulletin 10-15: Health Care Claims Data Submission - claims data reporting requirements
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission
Administrative Bulletin 10-14: Health Care Claims Data Submission
Related Regulation: 114.5 CMR 21.00 - Health Care Claims Data Submission

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Public Hearings and Public Comment Periods

 

Public Notice and
Regulatory Information
Relevant RegulationPublic Hearing Date, Time, and LocationPeriod to Submit Written CommentsRegister to Testify
 None at Present
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Please note: If you would like to testify at an upcoming public hearing, you may either sign up by email (CHIA-Regulations@state.ma.us) 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.

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