{ "meta": { "total": 19, "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": "f0111", "parent_org": "California DHCS", "plan_name": "Medi-Cal Dental Fee-for-Service", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CA", "reporting_period": "CY2025", "std_total": 3138788, "std_approved": 2212669, "std_denied": 926119, "std_denial_rate": 29.51, "std_denial_rate_printed": null, "std_appeals_total": 2430, "std_appeals_overturned": 1623, "std_appeal_overturn_rate": 66.79, "exp_total": null, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": 188, "std_tat_mean_days": 4.8, "std_tat_median_days": 5, "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://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/Medi-Cal-Dental-2025-Prior-Auth-Metrics.pdf", "source_segment": "states", "extraction_note": "Expedited not separately available. Median (5 days) exceeds mean (4.8). Of 24,230 extensions, only 188 approved and 24,042 denied." }, { "filing_id": "f0112", "parent_org": "California DHCS", "plan_name": "Medi-Cal Fee-for-Service (medical and behavioral health)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CA", "reporting_period": "CY2025", "std_total": 78987, "std_approved": 55741, "std_denied": 22404, "std_denial_rate": 28.36, "std_denial_rate_printed": null, "std_appeals_total": 43, "std_appeals_overturned": 3, "std_appeal_overturn_rate": 6.98, "exp_total": null, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": 774, "std_tat_mean_days": 4, "std_tat_median_days": 2, "exp_tat_mean_hours": null, "exp_tat_median_hours": null, "reports_counts": true, "quality_flags": "warn:std_headline_excludes_extended", "error_count": 0, "warn_count": 1, "source_url": "https://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/Medi-Cal-2025-Prior-Auth-Metrics.pdf", "source_segment": "states", "extraction_note": "Expedited data explicitly not available; standard and expedited reported together. Third outcome category 'Modified' = 842. CONTRADICTION: prints 3 of 43 appeals approved but labels it 14%; 3/43 is 7%. Also reports 9,439 auto-denied after extension." }, { "filing_id": "ca-ccs-2025", "parent_org": "California DHCS", "plan_name": "California Children's Services (CCS)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CA", "reporting_period": "CY2025", "std_total": 755850, "std_approved": 555301, "std_denied": 200549, "std_denial_rate": 26.53, "std_denial_rate_printed": null, "std_appeals_total": 15, "std_appeals_overturned": 1, "std_appeal_overturn_rate": 6.67, "exp_total": null, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": 304799, "std_tat_mean_days": 9, "std_tat_median_days": 2, "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://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/CCS-2025-Prior-Auth-Metrics.pdf", "source_segment": "filings_2025", "extraction_note": "Document states all prior authorizations (standard and expedited) are reported together, so the denominator is combined. Headline figures are 555,301 approved / 200,549 denied of 755,850 (73%/27%); the 442,990 / 139,846 pair printed alongside is the within-7-days subset, not the total. Two independent extraction passes disagreed on which pair was the headline; resolved to the document total." }, { "filing_id": "f0530", "parent_org": "Virginia DMAS", "plan_name": "Virginia Medicaid Fee-for-Service (Cardinal Care FFS)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "VA", "reporting_period": "CY2025", "std_total": 724465, "std_approved": 547433, "std_denied": 177032, "std_denial_rate": 24.44, "std_denial_rate_printed": null, "std_appeals_total": 11298, "std_appeals_overturned": 969, "std_appeal_overturn_rate": 8.58, "exp_total": 11501, "exp_approved": 8465, "exp_denied": 3036, "exp_denial_rate": 26.4, "ext_review_approved": 17194, "std_tat_mean_days": 5.2, "std_tat_median_days": null, "exp_tat_mean_hours": 75.8, "exp_tat_median_hours": null, "reports_counts": true, "quality_flags": "clean", "error_count": 0, "warn_count": 0, "source_url": "https://www.dmas.virginia.gov/media/mgokjgph/ffs-cy2025-annual-prior-authorization-cms-report.pdf", "source_segment": "states", "extraction_note": "Medians reported per FFS contractor only, not aggregated. Expedited mean TAT of 75.8 hours exceeds the 72-hour standard." }, { "filing_id": "f0195", "parent_org": "Colorado HCPF", "plan_name": "Health First Colorado / CHP+ (13 PA programs combined)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CO", "reporting_period": "CY2025", "std_total": 1746685, "std_approved": 1349135, "std_denied": 389506, "std_denial_rate": 22.3, "std_denial_rate_printed": null, "std_appeals_total": 890401, "std_appeals_overturned": 5026, "std_appeal_overturn_rate": 0.56, "exp_total": 165713, "exp_approved": 119832, "exp_denied": 45653, "exp_denial_rate": 27.55, "ext_review_approved": 82987, "std_tat_mean_days": 5.62, "std_tat_median_days": 1.46, "exp_tat_mean_hours": 26.4, "exp_tat_median_hours": 10.32, "reports_counts": true, "quality_flags": "clean", "error_count": 0, "warn_count": 0, "source_url": "https://hcpf.colorado.gov/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f", "source_segment": "states", "extraction_note": "The 890,401 'appeals' denominator is the state's own unexplained basis for its approved-after-appeal metric, not an appeal count. Expedited approved uses 165,713 while expedited denied uses 165,719. State caveat: RAE data incomplete after new contracts effective July 1, 2025." }, { "filing_id": "f0351", "parent_org": "Ohio Department of Medicaid", "plan_name": "Ohio Medicaid Fee-for-Service", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "OH", "reporting_period": "CY2025", "std_total": 30872, "std_approved": 25591, "std_denied": 5281, "std_denial_rate": 17.11, "std_denial_rate_printed": null, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 5268, "exp_approved": 4590, "exp_denied": 678, "exp_denial_rate": 12.87, "ext_review_approved": null, "std_tat_mean_days": 4, "std_tat_median_days": 2, "exp_tat_mean_hours": 48, "exp_tat_median_hours": 0, "reports_counts": true, "quality_flags": "info:appeals_not_reported", "error_count": 0, "warn_count": 0, "source_url": "https://dam.assets.ohio.gov/image/upload/medicaid.ohio.gov/Providers/Billing/PriorAuthorization/Fee_For_Service_FinalPDF_wAltText.pdf", "source_segment": "states", "extraction_note": "ODM states it does not capture hours, only days; same-day shows as 0. No appeal or extension counts in the FFS document." }, { "filing_id": "f0196", "parent_org": "Commonwealth of Massachusetts", "plan_name": "Calendar Year 2025 Prior Authorization Metrics (program not named in document)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "MA", "reporting_period": "CY2025", "std_total": null, "std_approved": null, "std_denied": null, "std_denial_rate": 14.56, "std_denial_rate_printed": 14.56, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": 29.51, "exp_total": null, "exp_approved": null, "exp_denied": null, "exp_denial_rate": 21.81, "ext_review_approved": null, "std_tat_mean_days": 4.21, "std_tat_median_days": 1.96, "exp_tat_mean_hours": 32, "exp_tat_median_hours": 2, "reports_counts": false, "quality_flags": "info:appeals_not_reported; info:percentages_only", "error_count": 0, "warn_count": 0, "source_url": "https://www.mass.gov/doc/calendar-year-2025-prior-authorization-metrics-0/download", "source_segment": "sweep", "extraction_note": "LOW-CONFIDENCE ATTRIBUTION: the document text contains only the metrics table, with no title block, organization, program name, or reporting period. Org/state/coverage attributed from the mass.gov hosting and file title alone. Percentages only." }, { "filing_id": "f0535", "parent_org": "Wyoming Department of Health", "plan_name": "Wyoming Medicaid Utilization Management (FFS)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "WY", "reporting_period": "CY2025", "std_total": 10708, "std_approved": 9294, "std_denied": 1106, "std_denial_rate": 10.33, "std_denial_rate_printed": null, "std_appeals_total": 20, "std_appeals_overturned": 5, "std_appeal_overturn_rate": 25, "exp_total": 0, "exp_approved": 0, "exp_denied": 0, "exp_denial_rate": null, "ext_review_approved": 0, "std_tat_mean_days": 3, "std_tat_median_days": 1, "exp_tat_mean_hours": null, "exp_tat_median_hours": null, "reports_counts": true, "quality_flags": "error:std_counts_reconcile", "error_count": 1, "warn_count": 0, "source_url": "https://health.wyo.gov/wp-content/uploads/2026/03/INTEROPERABILITY_Utilization-Management.pdf", "source_segment": "wave2", "extraction_note": "Approved + denied (10,400) does not reconcile to the printed 10,708 total." }, { "filing_id": "f0316", "parent_org": "Mississippi Division of Medicaid", "plan_name": "Mississippi Medicaid Fee-for-Service", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "MS", "reporting_period": "CY2025", "std_total": 60252, "std_approved": 52480, "std_denied": 6119, "std_denial_rate": 10.16, "std_denial_rate_printed": null, "std_appeals_total": 991, "std_appeals_overturned": 720, "std_appeal_overturn_rate": 72.65, "exp_total": 39, "exp_approved": 32, "exp_denied": 6, "exp_denial_rate": 15.38, "ext_review_approved": null, "std_tat_mean_days": 3.13, "std_tat_median_days": 1, "exp_tat_mean_hours": 110.26, "exp_tat_median_hours": 27, "reports_counts": true, "quality_flags": "error:std_counts_reconcile; warn:expedited_slower_than_standard", "error_count": 1, "warn_count": 1, "source_url": "https://medicaid.ms.gov/wp-content/uploads/2026/03/FFS-CY2025-Prior-Authorization-Metrics_MS_3.31.26.pdf", "source_segment": "states", "extraction_note": "Three-way outcome split; 'partially denied' (1,653 standard) is a separate category not folded into denied. Expedited mean TAT 110.26 hours far exceeds the 72-hour standard on a base of 39 requests." }, { "filing_id": "f0252", "parent_org": "Hawaii Med-QUEST", "plan_name": "Med-QUEST aggregate (QUEST Integration plans plus FFS)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "HI", "reporting_period": "CY2025", "std_total": 122333, "std_approved": null, "std_denied": null, "std_denial_rate": 8.3, "std_denial_rate_printed": 8.3, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 19581, "exp_approved": null, "exp_denied": null, "exp_denial_rate": 2.9, "ext_review_approved": null, "std_tat_mean_days": 4.2, "std_tat_median_days": 1, "exp_tat_mean_hours": 17.3, "exp_tat_median_hours": 7, "reports_counts": false, "quality_flags": "info:appeals_not_reported; info:percentages_only", "error_count": 0, "warn_count": 0, "source_url": "https://medquest.hawaii.gov/content/dam/formsanddocuments/med-quest/prior-authorization-reporting-metrics/Prior%20Auth%20CY%202025_updated%206.2026.pdf", "source_segment": "states", "extraction_note": "Totals plus percentages only, no approved/denied counts. Managed care and FFS are blended into one aggregate with no per-plan breakout." }, { "filing_id": "f0209", "parent_org": "Connecticut DSS", "plan_name": "Connecticut Medicaid (HUSKY) FFS - Medical", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CT", "reporting_period": "CY2025", "std_total": 254570, "std_approved": 238189, "std_denied": 16381, "std_denial_rate": 6.43, "std_denial_rate_printed": null, "std_appeals_total": 2362, "std_appeals_overturned": 907, "std_appeal_overturn_rate": 38.4, "exp_total": 3600, "exp_approved": 3118, "exp_denied": 482, "exp_denial_rate": 13.39, "ext_review_approved": 5688, "std_tat_mean_days": 2, "std_tat_median_days": 0, "exp_tat_mean_hours": 32, "exp_tat_median_hours": 3, "reports_counts": true, "quality_flags": "clean", "error_count": 0, "warn_count": 0, "source_url": "https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/hit/interoperability/cms-prior-authorization-metrics_march-2026.pdf", "source_segment": "states", "extraction_note": "One PDF holds two separate FFS filings (Medical and Behavioral Health). TATs converted from days+hours format." }, { "filing_id": "f0315", "parent_org": "Michigan Department of Health and Human Services", "plan_name": "Michigan Medicaid Home and Community Based Services (Aging and Community Services Division, incl. Brain Injury Services and Community Transition Services) - Fee-for-Service", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "MI", "reporting_period": "CY2025", "std_total": 3371, "std_approved": 3165, "std_denied": 175, "std_denial_rate": 5.19, "std_denial_rate_printed": 5.19, "std_appeals_total": 0, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": null, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": null, "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": "error:std_counts_reconcile", "error_count": 1, "warn_count": 0, "source_url": "https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Medicaid-Provider-Assets/CHAMPS/HCBS-2025-Prior-Authorization-Annual-Report.pdf?rev=870074c81a0c4cb09e5f61c77b72c9c8&hash=7F9B18D0B199E145BE70AFF7F2D04825", "source_segment": "w3_midwest", "extraction_note": "Document reports one combined total (3,371 requests; 3,165 approved/93.89%; 175 denied/5.19%) and does NOT split standard vs. expedited. The document itself states that standard/expedited breakout 'is a requirement of CMS-0057-F' but 'Fee-for-Service Michigan Medicaid implementation of collection of this data is effective 4/1/2026' -- so CY2025 requests are combined. Recorded the combined counts under std_total/std_approved/std_denied for lack of a better bucket; treat as combined, not standard-only. Turnaround time was 'not actively tracked in 2025' -- left null, not estimated. Appeals row printed 'Number of PA Requests with a Decision Outcome following Appeal: 0' -- recorded as std_appeals_total=0 (a real printed zero, not an absence) but it is unclear whether this denominator counts appeals filed or appeals decided; treat cautiously. Approved (3,165) + denied (175) = 3,340, not 3,371 -- recorded as printed; the shortfall is presumably pending/withdrawn requests not broken out." }, { "filing_id": "f0533", "parent_org": "Wisconsin Department of Health Services", "plan_name": "Wisconsin Medicaid (ForwardHealth) -- specific program/agency not named in document", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "WI", "reporting_period": "Reporting Year 2025", "std_total": 165012, "std_approved": 148796, "std_denied": 6556, "std_denial_rate": 3.97, "std_denial_rate_printed": 4, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 10, "exp_approved": 9, "exp_denied": 0, "exp_denial_rate": 0, "ext_review_approved": null, "std_tat_mean_days": 3.1, "std_tat_median_days": 1, "exp_tat_mean_hours": 151.2, "exp_tat_median_hours": 67.2, "reports_counts": true, "quality_flags": "error:std_counts_reconcile; info:appeals_not_reported; warn:expedited_slower_than_standard", "error_count": 1, "warn_count": 1, "source_url": "https://www.dhs.wisconsin.gov/medicaid/pa-report-2025.pdf", "source_segment": "w3_midwest", "extraction_note": "Document title is only 'Prior Authorization Metrics Reporting Year 2025' -- it names no specific plan, MCO, or program (no BadgerCare Plus / ForwardHealth / managed-care label appears). Hosted on the WI DHS Medicaid pages alongside ForwardHealth FFS pharmacy/PA administrative-code material, so classified here as Medicaid FFS, but this could instead be a statewide combined FFS+MCO carve-in PA determination log -- flag for verification by someone who can see the full PDF. Document also reports a separate 'Partially Denied' bucket not in this schema: standard 9,660 (5.9%%), expedited 1 -- omitted from typed fields, noted here. Standard TAT is explicitly labeled in days (3.1 mean / 1.0 median). Expedited TAT is ALSO explicitly labeled in days (6.3 mean / 2.8 median) rather than hours; converted per brief instructions (days->hours: 6.3*24=151.2, 2.8*24=67.2) and flagged as a conversion. Note the apparent anomaly that expedited turnaround (151.2h / 67.2h) is far slower than standard (3.1 days = 74.4h / 1.0 day = 24h) -- printed as-is; worth scrutiny downstream. No appeals data reported." }, { "filing_id": "utah-medicaid-2025", "parent_org": "Utah DHHS", "plan_name": "Utah Medicaid", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "UT", "reporting_period": "CY2025", "std_total": 29879, "std_approved": 29056, "std_denied": 823, "std_denial_rate": 2.75, "std_denial_rate_printed": null, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 94, "exp_approved": 92, "exp_denied": 2, "exp_denial_rate": 2.13, "ext_review_approved": 182, "std_tat_mean_days": 4.81, "std_tat_median_days": 4, "exp_tat_mean_hours": 107.52, "exp_tat_median_hours": 96, "reports_counts": true, "quality_flags": "info:appeals_not_reported", "error_count": 0, "warn_count": 0, "source_url": "https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/Prior%20Authorization%20Annual%20Metrics%20Report_2025.pdf", "source_segment": "filings_2025", "extraction_note": "Expedited mean turnaround (4.48 days) exceeds the standard-request expedited norm and approaches the standard mean; flagged for review." }, { "filing_id": "f0003", "parent_org": "Alaska Department of Health", "plan_name": "Alaska Medicaid (fee-for-service)", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "AK", "reporting_period": "CY2025", "std_total": 430236, "std_approved": 421217, "std_denied": 9019, "std_denial_rate": 2.1, "std_denial_rate_printed": null, "std_appeals_total": 34, "std_appeals_overturned": 13, "std_appeal_overturn_rate": 38.24, "exp_total": 106213, "exp_approved": 105009, "exp_denied": 1204, "exp_denial_rate": 1.13, "ext_review_approved": 7024, "std_tat_mean_days": 1, "std_tat_median_days": 1, "exp_tat_mean_hours": 24, "exp_tat_median_hours": 24, "reports_counts": true, "quality_flags": "clean", "error_count": 0, "warn_count": 0, "source_url": "https://health.alaska.gov/en/education/service-authorizations/2025-prior-authorization-metrics/", "source_segment": "states", "extraction_note": "Expedited TAT published in days, x24. Extended-timeframe figures are standard-only." }, { "filing_id": "f0208", "parent_org": "Connecticut DSS", "plan_name": "Connecticut Medicaid (HUSKY) FFS - Behavioral Health", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "CT", "reporting_period": "CY2025", "std_total": 105020, "std_approved": 104144, "std_denied": 876, "std_denial_rate": 0.83, "std_denial_rate_printed": null, "std_appeals_total": 297, "std_appeals_overturned": 182, "std_appeal_overturn_rate": 61.28, "exp_total": 70102, "exp_approved": 69324, "exp_denied": 778, "exp_denial_rate": 1.11, "ext_review_approved": 0, "std_tat_mean_days": 1.57, "std_tat_median_days": 0, "exp_tat_mean_hours": 6.42, "exp_tat_median_hours": 0.42, "reports_counts": true, "quality_flags": "clean", "error_count": 0, "warn_count": 0, "source_url": "https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/hit/interoperability/cms-prior-authorization-metrics_march-2026.pdf", "source_segment": "states", "extraction_note": "Expedited volume (70,102) is unusually high relative to standard (105,020) for a behavioral health book." }, { "filing_id": "f0348", "parent_org": "New Jersey DMAHS", "plan_name": "NJ FamilyCare / Medicaid Fee-for-Service", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "NJ", "reporting_period": "CY2025", "std_total": 889627, "std_approved": 883132, "std_denied": 2388, "std_denial_rate": 0.27, "std_denial_rate_printed": null, "std_appeals_total": null, "std_appeals_overturned": 0, "std_appeal_overturn_rate": null, "exp_total": 0, "exp_approved": 0, "exp_denied": 0, "exp_denial_rate": null, "ext_review_approved": 1266, "std_tat_mean_days": 1, "std_tat_median_days": 1, "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://www.nj.gov/humanservices/dmahs/documents/news/metrix/CY-2025-FFS-Prior-Authorization-Metrics-Report.pdf", "source_segment": "states", "extraction_note": "Counts do not reconcile: 883,132 + 2,388 = 885,520 against a stated total of 889,627; 4,107 unexplained. Reported expedited volume is literally zero." }, { "filing_id": "f0305", "parent_org": "Magellan Healthcare", "plan_name": "Wyoming High Fidelity Wraparound CME", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "WY", "reporting_period": "CY2025", "std_total": 1049, "std_approved": null, "std_denied": null, "std_denial_rate": 0, "std_denial_rate_printed": 0, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 0, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": null, "std_tat_mean_days": 8, "std_tat_median_days": 7, "exp_tat_mean_hours": null, "exp_tat_median_hours": null, "reports_counts": false, "quality_flags": "info:appeals_not_reported; warn:zero_denial_rate; info:percentages_only", "error_count": 0, "warn_count": 1, "source_url": "https://health.wyo.gov/wp-content/uploads/2026/03/Wyoming-2025-Interoperability-Data-rev.-3.18.2026.pdf", "source_segment": "wave2", "extraction_note": "Only the total is a count; outcomes published as percentages (100% approved). No expedited requests received. Standard mean of 8 days exceeds the 7-day standard." }, { "filing_id": "f0534", "parent_org": "Wyoming Department of Health", "plan_name": "Wyoming Medicaid Home and Community Based Services", "contract_id": null, "coverage_type": "Medicaid FFS", "state": "WY", "reporting_period": "CY2025", "std_total": 32044, "std_approved": 32044, "std_denied": 0, "std_denial_rate": 0, "std_denial_rate_printed": null, "std_appeals_total": null, "std_appeals_overturned": null, "std_appeal_overturn_rate": null, "exp_total": 0, "exp_approved": null, "exp_denied": null, "exp_denial_rate": null, "ext_review_approved": null, "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": "info:appeals_not_reported; warn:zero_denial_rate", "error_count": 0, "warn_count": 1, "source_url": "https://health.wyo.gov/wp-content/uploads/2026/03/INTEROPERABILITY_HCBS-2025.pdf", "source_segment": "wave2", "extraction_note": "Turnaround printed as the text 'less than 24 hours', not a number. Document states 'Wyoming HCBS approves all services in the budget. The system is designed to not allow services that would be denied.'" } ] }