Code of Massachusetts Regulations 957 CMR - CENTER FOR HEALTH INFORMATION AND ANALYSIS
Here’s a structured overview of 957 CMR – Massachusetts regulations under the Center for Health Information and Analysis (CHIA), as codified in the Code of Massachusetts Regulations:
📋 Overview of 957 CMR by Part
957 CMR 2.00 – Payer Data Reporting
Sets methodology and filing requirements for health care payers on topics like health status‑adjusted total medical expenses, relative prices, alternative payment methods, prescription drug rebates, and primary care/behavioral health expenses (sec.state.ma.us).
957 CMR 3.00 – Assessment on Certain Health Care Providers and Surcharge Payors
Governs payments by acute hospitals, ambulatory surgical centers, and surcharge payors to CHIA (chiamass.gov).
957 CMR 4.00 – Uniform Provider Reporting of Standard Quality Measure Set
Requires providers to report specified performance measures in a consistent standard set (chiamass.gov).
957 CMR 5.00 – Health Care Claims, Case Mix and Charge Data Release Procedures
Details CHIA procedures for releasing payer data, hospital case mix data, and hospital charge data (chiamass.gov).
957 CMR 6.00 – Cost Reporting Requirements
Defines reporting duties for a range of provider types—including home health, nursing, adult day, ambulance, community health centers—effective Dec 20 2024 (chiamass.gov).
957 CMR 7.00 – Nursing Facilities Cost Reporting Requirements
Specifies cost reporting timelines and protocol for nursing (resident care) facilities (chiamass.gov).
957 CMR 8.00 – All Payer Claims Database (APCD) & Case Mix and Charge Data Submission
Covers mandated file submission guidelines for APCD and hospital case/charge data; recently updated for FY 2026 to add new data elements and format changes (chiamass.gov).
957 CMR 9.00 – Hospital Financial Data Reporting Requirements
Acute and non‑acute hospitals must submit cost reports, audited statements, charge books, compensation data for top ten employees, and are subject to audits. Annual cost reports due by April 1 (or within 180 days for fiscal years ending Oct–Dec) (chiamass.gov).
957 CMR 10.00 – Health Care Payers Premiums and Claims Data Reporting Requirements
Mandates annual submission by private payers (with >50,000 MA members) of premiums, allowed/incurred claims, administrative fees, and rating factors. Submissions cover the prior three calendar years and are due by May 10. Enforces penalties up to $1,000/week (capped at $50,000) (mass.gov, chiamass.gov).
957 CMR 11.00 – Registered Provider Organizations Reporting Requirements
Covers RPO data submissions: procedures, deadlines, certification, waivers, administrative fees, review and penalties up to $1,000/week (max $50,000) (masshpc.gov).
✅ Key Updates
December 17–20, 2024: Major amendments adopted across 957 CMR 2.00, 6.00, 10.00, and 11.00—updating definitions, submission procedures, deadlines, and enforcement mechanisms .
Recently (June 2025): CHIA revised FY 2026 guidelines for 957 CMR 8.00, adding fields such as clinician NPI and an asterisk-delimited format for outpatient observation data (chiamass.gov).
🔍 Where to Find Official Versions
Mass.gov/Trial Court Law Libraries page offers compiled PDFs of each regulation, last updated December 20, 2024 (mass.gov).
CHIA’s website and PDFs supply administrative bulletins, data submission manuals, and full‑text regulations per part (e.g., 5.00, 6.00, 8.00, 10.00, 11.00).
Third-party sites like Justia and Cornell LII also host versions—with caveats that they might not reflect the latest amendments (chiamass.gov).
📌 In Summary
957 CMR outlines statewide data reporting and financial submission standards for payers, providers, hospitals, nursing homes, RPOs, and CHIA itself. The regulations are updated periodically to refine requirements, extend deadlines, and integrate new data elements. For official and up-to-date texts, rely on Mass.gov or CHIA’s site.
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