Code of Massachusetts Regulations 114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY
Here’s an organized overview of 114 CMR – the Division of Health Care Finance and Policy (DHCFP) in Massachusetts:
🏛️ Structure of 114 CMR
This Title is divided into several subtitles and chapters, which include:
114.1 CMR: Hospital and Institutional Rates
36.00 – Acute care hospital charges & Medicaid payment methodology (effective Dec 1, 2007) (mass.gov, regulations.justia.com)
39.00 – Chronic & rehab rates + residential alcoholism treatment (regulations.justia.com)
40.00 – Non-acute hospital & residential alcoholism program rates (mass.gov)
41.00 – Rates for industrial‑accident (workers’ compensation) hospital services (effective Apr 1, 2009) (law.cornell.edu)
114.2 & 114.3 CMR: Facility-Specific & Worker’s Comp
114.2 & 114.3 contain specialized topics, like nursing facility payments and workers’ comp standards — many sections have been repealed or re‑promulgated elsewhere (law.cornell.edu)
114.5 CMR: Fees & Reporting
Section 4 – Rates for social, rehab, and consultant services
Section 10 – Elder care grants
Section 23 – Payer reporting of medical expenses and relative prices
Section 11 – Health plan data submission (HEDIS, CAHPS) (sec.state.ma.us, mass.gov, chiamass.gov)
114.6 CMR: Free Care Eligibility & Patient Rights
10.00 – Eligibility criteria for free/charity care at hospitals and health centers, including patient rights and responsibilities (regulations.justia.com)
🔍 Key Highlights by Chapter
114.1 CMR 36: Defines how DHCFP calculates Medicaid rates—covers inpatient, outpatient, DSH payments, safety-net adjustments, penalties, mergers, and data reporting (mass.gov).
114.1 CMR 39: Covers payment rates for chronic/rehab care and fees for alcoholism treatment programs (sec.state.ma.us).
114.1 CMR 41: Workflow and rates for industrial accident services—both inpatient and outpatient—authorized under workers’ compensation (law.cornell.edu).
114.6 CMR 10: Ensures hospitals inform patients of free care rights and outlines grievance and application processes (regulations.justia.com).
114.5 CMR 11: Mandates health insurance plans report data like HEDIS and CAHPS for transparency (chiamass.gov).
📌 Need More Detail?
If you'd like to explore a specific section—say the rate formulas under 36.05 or the full text of 39.04—just let me know, and I can pull up the relevant PDF or legal text.
You can also view the official versions or downloadable PDFs at the Massachusetts DHCFP site (Mass.gov's 114 CMR) (regulations.justia.com, mass.gov).
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