Prescription Drug Rebate Data Submission

Overview

M.G.L. c. 12C, § 16(a) requires that CHIA “consider the effect of drug rebates and other price concessions in the aggregate without disclosure of any product or manufacturer-specific rebate or price concession information, and without limiting or otherwise affecting the confidential or proprietary nature of any rebate or price” when detailing cost growth trends in its annual report.

As per regulation 957 CMR 2.00 (Payer Data Reporting) and the latest Administrative Bulletins, CHIA requires payers to submit a prescription drug rebate data file. This data will permit consideration of the effect of prescription drug rebates and other pharmaceutical manufacturer price concessions such as coverage gap discounts on aggregate cost growth trends

Reporting Requirements

All prescription drug rebate data will be submitted by using a pre-formatted Excel template. Reports are required to be submitted through CHIA’s Web-Based Submission Platform which requires data submitter registration via a CHIA Data Reporter User Agreement.

The Prescription Drug Rebate Data Specification Manual provides additional technical details to assist payers in reporting and filing prescription drug rebate data.

Prescription drug rebate files will contain different record types, including:

• Payer summary information and comments
• Member Months, by Massachusetts residency or approved approximation
• Gross Pharmacy Expenditures, by insurance category and brand status
• Prescription Drug Rebates, by insurance category and brand status
• Coverage Gap Discounts for Medicare business
• Pharmacy Benefit Manager (PBM) contract summary information

Web-Based Submission Platform Registration Information

New users must register to submit data via CHIA Submissions.

1. Complete and sign the CHIA Data Reporter User Agreement after reviewing the DRUA instructions. Note that each individual user for an organization must complete the form.
2. Submit the completed Data Reporter User Agreement to DL-Data-Submitter-HelpDesk@chiamass.gov.
3. You will be notified when your account is ready to use.

For help with registration, email DL-Data-Submitter-HelpDesk@chiamass.gov or call 617-701-8100 (9am-5pm Monday through Friday).

Contact

For questions specifically related to prescription drug rebate reporting, please email Joseph Vincent at Joseph.Vincent@chiamass.gov. Please include the subject line "Prescription Drug Rebate Data Submission."

Related Links

CHIA Regulation and Administrative Bulletins