Payer Data Reporting

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.

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

Submission Deadline

Complete data files are due no later than September 9, 2026.

Submission Resources (2026)
Prescription Drug Rebate Data Specification Manual (PDF) Prescription Drug Rebate Data Submission Template (Excel) Prescription Drug Rebate Data Submission Example (Excel) Medical Pharmacy Codes (Excel)

Reporting Requirements

All prescription drug rebate data will be submitted by using the pre-formatted Excel template and uploading to CHIA Submissions (see below). 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

Registration Instructions

New users must register to submit data via CHIA Submissions.

1

Complete User Agreement

Complete and sign the CHIA Data Reporter User Agreement (DRUA) after reviewing the DRUA instructions. Note that each individual user for an organization must complete the form.

2

Submit User Agreement

Submit the completed Data Reporter User Agreement to DL-Data-Submitter-HelpDesk@chiamass.gov. You will be notified when your account is ready to use.

Get Support

For questions specifically related to prescription drug rebate reporting, email Joseph Vincent at Joseph.Vincent@chiamass.gov with the subject line “Prescription Drug Rebate Data Submission.”

Recommended Links

Prescription Drug Use and Spending Report

Explore CHIA's data and reports on prescription drug spending, pricing trends, and pharmaceutical costs in the Massachusetts health care system.

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Payer Expenditure & Utilization Data

CHIA’s aggregate payer data collects information from commercial health insurance plans in Massachusetts to support a better understanding of health care costs, spending trends, and how care is delivered across the state.

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CHIA Regulations (CMR)

Access CHIA's regulations governing health care data collection and reporting in Massachusetts, including current rules, administrative bulletins, and hearings.

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