{
    "meta": {
        "total": 3,
        "page": 1,
        "per_page": 50,
        "pages": 1,
        "sort": "rate",
        "direction": "desc",
        "reporting_year": "CY2025",
        "rule": "CMS-0057-F",
        "note": "Rates are computed from published counts. null means the payer published no value; it never means zero."
    },
    "filings": [
        {
            "filing_id": "f0336",
            "parent_org": "Inland Empire Health Plan",
            "plan_name": "IEHP Covered California",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "CA",
            "reporting_period": "CY2025",
            "std_total": 378624,
            "std_approved": 370653,
            "std_denied": 7971,
            "std_denial_rate": 2.11,
            "std_denial_rate_printed": null,
            "std_appeals_total": null,
            "std_appeals_overturned": 103,
            "std_appeal_overturn_rate": null,
            "exp_total": 82531,
            "exp_approved": 80368,
            "exp_denied": 2163,
            "exp_denial_rate": 2.62,
            "ext_review_approved": 0,
            "std_tat_mean_days": 2.59,
            "std_tat_median_days": 1.04,
            "exp_tat_mean_hours": 13.44,
            "exp_tat_median_hours": 0.48,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.iehp.org/content/dam/iehp-org/en/documents/medi-cal/prior-authorization/2025/report/CY26_PriorAuthReport2025_EN-update.pdf",
            "source_segment": "w5_states",
            "extraction_note": "Transcribed from IEHP's three-column infographic report; the same document is published under each product's path. Columns are Medi-Cal, DualChoice (D-SNP) and Covered California. The three unlabeled figures per column are denied, approved after appeal, and approved, which reconcile against the printed total. IEHP counts partial approvals as denials and continuations as urgent, per its own notes. Appeal totals are not printed — only the percentage approved after appeal — so appeal counts stay null. Decision times are printed in days for both classes; urgent converted to hours.",
            "source_sha256": "1d4c480f7340200ab0c51c300c627c6e958ecdaa9230c201376ddc5af02f33a3",
            "service_list_url": "https://www.iehp.org/content/dam/iehp-org/en/documents/medi-cal/prior-authorization/list/CY26_Prior-Authorization-List_EN.pdf",
            "service_list_items": null,
            "entity_id": null,
            "filing_unit": null
        },
        {
            "filing_id": "f0362",
            "parent_org": "L.A. Care Health Plan",
            "plan_name": "L.A. Care Medi-Cal",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "CA",
            "reporting_period": null,
            "std_total": 2152883,
            "std_approved": 2112850,
            "std_denied": 40033,
            "std_denial_rate": 1.86,
            "std_denial_rate_printed": 1.86,
            "std_appeals_total": 2112850,
            "std_appeals_overturned": 165,
            "std_appeal_overturn_rate": 0.01,
            "exp_total": 350767,
            "exp_approved": 337522,
            "exp_denied": 13245,
            "exp_denial_rate": 3.78,
            "ext_review_approved": 8043,
            "std_tat_mean_days": null,
            "std_tat_median_days": null,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://lacare.org/sites/default/files/la7598_mcla_cms57f_pa_report_202603.pdf",
            "source_segment": "w5_cms_template",
            "extraction_note": "parsed from the CMS reporting template by pipeline.preauth.extract (cms)",
            "source_sha256": "c39bb7fd526749665de4c4eb30c8e3f1fbcf91ceb5ac423a8faf676ba0dcb6c0",
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": null,
            "filing_unit": null
        },
        {
            "filing_id": "f0363",
            "parent_org": "L.A. Care Health Plan",
            "plan_name": "L.A. Care Medicare Plus (HMO D-SNP)",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "CA",
            "reporting_period": null,
            "std_total": 284406,
            "std_approved": 281471,
            "std_denied": 2935,
            "std_denial_rate": 1.03,
            "std_denial_rate_printed": 1.03,
            "std_appeals_total": 281471,
            "std_appeals_overturned": 31,
            "std_appeal_overturn_rate": 0.01,
            "exp_total": 31016,
            "exp_approved": 30377,
            "exp_denied": 639,
            "exp_denial_rate": 2.06,
            "ext_review_approved": 32,
            "std_tat_mean_days": null,
            "std_tat_median_days": null,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://lacare.org/sites/default/files/la7598_dsnp_cms57f_pa_report_202603.pdf",
            "source_segment": "w5_cms_template",
            "extraction_note": "parsed from the CMS reporting template by pipeline.preauth.extract (cms)",
            "source_sha256": "5e2564131b165356ac8a5552cd40bf0589fc422fe255e095f5f33ec9fba60833",
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": null,
            "filing_unit": null
        }
    ]
}