HIway Regulations Overview

Mass HIway Regulations

In February 2017, EOHHS, the Massachusetts Executive Office of Health & Human Services, promulgated 101 CMR 20.00: Health Information Exchange, also known as the Mass HIway Regulations. These regulations implement key components of Chapter 118I of the Massachusetts General Laws, which pertain to the Mass HIway.

The regulations codify the HIway Connection Requirement, which requires certain healthcare organizations to connect to and use the Mass HIway. These organizations must implement increasingly rigorous clinical use cases by sending/receiving HIway Direct messages over a four-year cycle. For a summary of the regulations, click here.

The regulations also established a mechanism to allow patients to opt-in and opt-out of the Mass HIway, and provide HIway participants the option to distribute a fact sheet for patients.

The HIway Connection Requirement

The regulations stipulate that the HIway Connection Requirement is phased in by type of organization, and currently applies to the following Provider Organizations:

  • Acute Care Hospitals
  • Medium and Large Medical Ambulatory Practices
  • Community Health Centers

The HIway Regulations align HIway Direct Messaging with other modes of transmission, e.g. fax or phone, and require these organizations to:

  • Transmit health information via HIway Direct Messaging
  • Comply with federal and state privacy laws and implementation regulations
  • Meet specific HIE Use Case requirements when using the Mass HIway
  • Attest that they comply with these regulations

If the HIway Regulations apply to your Provider Organization, you will need to connect to the Mass HIway, and submit documentation to attest that your organization complies with the HIway Connection Requirement.

Timeline for Provider Organizations to connect

The table below shows the year by which Provider Organizations must connect to the Mass HIway.

Provider Organization First Year of Requirement
Acute Care Hospitals 2017
Large and Medium Medical Ambulatory Practices 2018
Large Community Health Centers
Small Community Health Centers 2019

Four Year Phase-In Period

How provider organizations must fulfill the HIway Connection Requirement is phased in over 4 years:

  1. The connection requirement gets progressively stricter in each year of implementation
  2. Organizations that don’t meet the requirement may be subject to penalties starting in Year 4
  3. The 4 year phase-in period is based on when an organization must be connected
Provider Organization Year 1 Year 4 2020 Requirement
Acute Care Hospitals 2017 2020 Year 4 Requirements
Large and Medium Medical Ambulatory Practices 2018 2021 Year 3 Requirements
Large Community Health Centers
Small Community Health Centers 2019 2022 Year 2 Requirements

Note: Provider types not yet specified in the regulations are anticipated to be required to connect at a future date.
         ○   Guidance to the affected providers will be provided with at least one year notice.

Progressive HIway Connection Requirements

The four year phase-in approach progressively encourages providers to use the Mass HIway for Provider-to-Provider Communications via bi-directional exchange of health information.

Year Requirements HIE Use Case Requirements
2020 Year 2 Send or receive HIway Direct Messages for at least one use case
    ○   Must be Provider-to-Provider Communications use case *
Year 3 Send HIway Direct Messages for at least one use case, and
Receive HIway Direct Messages for at least one use case
    ○   Both must be Provider-to-Provider Communications use cases
Year 4 Meet Year 3 requirement, or may be subject to penalties if requirement isn't met
    ○   Penalties go into effect in the applicable Year 4
         (e.g. Jan 2020 for Acute Care Hospitals)

* The Use Case categories are explained in the next section.

HIE Use Case Requirements

The table below lists the HIE Use Case categories allowed to be implemented to meet the Year 1 to Year 4 Requirements. Year 1 no longer applies to any providers. Providers in Year 2 to 4 need to implement a Provider-to-Provider Communications Use Case.

The use case examples listed in the table are for reference only, as other use cases may be suitable as well, provided these fit the categories allowed to satisfy the requirements. Note that the requirements are the minimum a provider must implement. To take advantage of the benefits of HIE, providers are encouraged to implement additional HIE use cases beyond the requirements.

Use Cases Allowed to meet HIway Regulations

The graphic below shows an example of a Provider-to-Provider Communications use case. You can use our HIE Use Case Toolkit to implement this use case or any other HIE Use Cases.

Use Case Example

Statewide ENS Framework Requirement

There is an additional ENS Requirement that applies only to Acute Care Hospitals. These organizations must connect to the Statewide ENS Framework to submit Admission Discharge Transfer notifications (ADTs) by April 1, 2021.

Note: The HIway is not asking Acute Care Hospitals to submit documentation to affirm that they are submitting ADTs by this deadline. To streamline the reporting process, Acute Care Hospitals will be asked to provide details regarding ADT submission on their HIway Connection Requirement attestation forms to be submitted in the fall of 2021.

To learn more about the Statewide ENS Framework and this requirement for Acute Care Hospitals, click here.

Frequently Asked Questions

Mass HIway Regulations FAQs provide Questions & Answers related to the Mass HIway Regulations, and the attestation process. To access the FAQs, click here.


Review the webinar below to learn more about the Mass HIway Connection Requirement and Attestation Process.

2020 HIway Connection Requirement and Attestation - Dec 2020 - PDF (ENS slide updated)




Contact The Mass HIway

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