Logo

Executive Office of Health and Human Services - Online Attestation Form

Mass HIway Connection Requirement

hiway-Logo

Welcome to the Mass HIway Attestation/Exception Webform

Please read this before requesting an online Attestation Form

A Mass HIway Attestation or Exception Form shall be completed by Provider Organizations in order to report compliance with the requirement that Provider Organizations connect to the Mass HIway in accordance with the Mass HIway Regulations (101 CMR 20.00).

The Mass HIway is the Commonwealth's statewide, state-sponsored health information exchange. For more information, visit the Mass HIway Regulations Summary and Mass HIway Regulations FAQ.

An authorized representative at the Provider Organization should complete and submit this attestation form between Aug. 1 and Dec. 31.

Important Messages

In order to access an online version of the Attestation/Exception forms, please submit your name and email below. An access code with instructions will be sent to the email address that you provide. You only need to request an access code once. The access code that you will receive can be used to access the Attestation Form at any time until you submit the completed Attestation Form.

IMPORTANT: We recommend that you use the PDF version of the Year 2 Attestation Form, Year 3 and 4 Attestation Form or HIE Requirement Exception Form to prepare your responses. You can complete the online version of the form when all of your responses are ready for submission.


Access the Attestation/Exception Form


* Please Enter a valid Name *
* Please Enter the valid Email *