Pharmacy Benefit Manager
(PBM) Resources
In 2025, Massachusetts enacted Chapter 342 of the Acts of 2024: An act relative to pharmaceutical access, costs, and transparency amending CHIA’s authority to require reporting from pharmacy benefit managers (PBMs).
In accordance with the new requirements outlined in M.G.L. c.12C § 10A, this data collection aims to facilitate analysis of wholesale acquisition costs, formulary and maximum allowable cost lists, and aggregated data on discounts, utilization limits, rebates, and administrative service fees. Additionally, the data will enable CHIA to track trends in estimated drug rebates and other aggregate price reductions, including the amounts of rebates retained and passed through to each carrier client or health plan sponsor.
957 CMR 12.00 governs the reporting requirements for Pharmacy Benefit Managers to submit health care data and information to the Center for Health Information and Analysis to ensure uniform reporting of information in accordance with M.G.L. c.12C.
On November 5, 2025, from 1-2pm, CHIA held a listening session to gather feedback on draft data submission materials and processes that will support compliance with the new PBM data reporting regulation. This input will help refine these tools to make these materials more user-friendly and ensure a seamless submission process that aligns with statutory requirements.
Prior to the session, CHIA distributed draft materials to session registrants, including the data collection template, formulary data template, and data specification manual.
Written feedback on the data submission materials can be submitted to RxData@chiamass.gov through Friday, November 14th.
CHIA filed 957 CMR 12.00 with the Massachusetts Secretary of State on October 10, 2025 and was published on CHIA’s website on October 24, 2025.
For questions specifically related to pharmacy benefit manager reporting, please email molly.bailey@chiamass.gov or RxData@chiamass.gov.
