{
    "meta": {
        "total": 28,
        "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": "f0330",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of South Carolina Medicaid",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "SC",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 27,
            "std_denial_rate_printed": 27,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 18,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 11,
            "ext_review_approved": null,
            "std_tat_mean_days": 8,
            "std_tat_median_days": 9,
            "exp_tat_mean_hours": 21,
            "exp_tat_median_hours": 20,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/sc/medicaid/forms/fuf.aspx",
            "source_segment": "wave2",
            "extraction_note": "Percentages only. Standard mean (8 days) below median (9 days) and both exceed the 7-day standard."
        },
        {
            "filing_id": "f0331",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas CHIP Medicaid",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 17,
            "std_denial_rate_printed": 17,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 78,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 11,
            "ext_review_approved": null,
            "std_tat_mean_days": 3,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": 47,
            "exp_tat_median_hours": 25,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Same source page, CHIP Medicaid table. No raw counts, percentages only. Standard-track appeal-approval shown (78%); expedited appeal-approval separately printed at 50%, no schema field, noted here only."
        },
        {
            "filing_id": "f0335",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas STAR",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 17,
            "std_denial_rate_printed": 17,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 54,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 9,
            "ext_review_approved": null,
            "std_tat_mean_days": 3,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": 44,
            "exp_tat_median_hours": 24,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Page displays six/seven CMS-0057-F metrics tables directly in HTML (one per Molina TX Medicaid/CHIP program); no raw approved/denied counts are shown, only percentages and turnaround times, so reports_counts is false. Turnaround is explicitly labeled: standard in days, expedited in hours (no conversion needed). Appeal-approval percentage shown (54%) is the standard-track figure; the page separately prints an expedited appeal-approval figure of 48% that has no schema field and is noted here only. Reporting-period label inferred as CY2025 (consistent with every other filing in this dataset); the page itself was not independently re-verified for the exact literal string."
        },
        {
            "filing_id": "f0328",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of New York Medicaid",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 16,
            "std_denial_rate_printed": 16,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 30,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 9,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 31,
            "exp_tat_median_hours": 25,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ny/medicaid/resource/utilized_mgt.aspx",
            "source_segment": "wave2",
            "extraction_note": "Rates only, no volumes."
        },
        {
            "filing_id": "f0337",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Washington (Apple Health)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "WA",
            "reporting_period": "CY2025",
            "std_total": 139980,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 16,
            "std_denial_rate_printed": 16,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 54,
            "exp_total": 15716,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 17,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 16,
            "exp_tat_median_hours": 11,
            "reports_counts": true,
            "quality_flags": "info:appeals_not_reported",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/wa/medicaid/resource/Utilization-Management.aspx",
            "source_segment": "wave2",
            "extraction_note": "Only totals are counts; approvals/denials/appeals published as rates only."
        },
        {
            "filing_id": "f0320",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Florida",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "FL",
            "reporting_period": "2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 15,
            "std_denial_rate_printed": 15,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 33,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 6,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 12,
            "exp_tat_median_hours": 5,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/fl/medicaid/forms/fuf.aspx",
            "source_segment": "w3_southeast",
            "extraction_note": "Table titled 'Florida Medicaid Prior Authorization Annual Report 2025' is embedded directly in this page's HTML (no separate PDF). Publishes percentages only, no underlying request counts -- std_total/std_approved/std_denied/exp_total/exp_approved/exp_denied omitted rather than derived. Standard approved was printed as 85% (denied 15%); expedited approved 94% (denied 6%). Document also prints an expedited 'approved after appeal' rate of 43% and 'approved after extended review, approved' rates of 53% (standard) and 67% (expedited) with no stated denominators and no schema field for extended-review percentages or expedited-appeal overturn rate -- recorded here rather than forced into an unrelated field. Verified with two independent fetches returning identical figures."
        },
        {
            "filing_id": "f0326",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of New Mexico (Turquoise Care)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "NM",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 15,
            "std_denial_rate_printed": 15,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 34,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 13,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": 30,
            "exp_tat_median_hours": 16,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/nm/medicaid/resource/priorauth.aspx",
            "source_segment": "wave2",
            "extraction_note": "Percentages only, published inline on the provider page."
        },
        {
            "filing_id": "f0334",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas CHIP RSA Medicaid",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 15,
            "std_denial_rate_printed": 15,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 76,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 7,
            "ext_review_approved": null,
            "std_tat_mean_days": 3,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": 45,
            "exp_tat_median_hours": 26,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Same source page, CHIP RSA Medicaid table. No raw counts, percentages only. Standard-track appeal-approval shown (76%); expedited appeal-approval separately printed at 100%, no schema field, noted here only."
        },
        {
            "filing_id": "f0322",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Illinois (Medicaid)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "IL",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 14,
            "std_denial_rate_printed": 14,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 52,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 8,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 20,
            "exp_tat_median_hours": 19,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/il/medicaid/forms/fuf.aspx",
            "source_segment": "w3_gaps_a",
            "extraction_note": "Table appears under the heading 'Illinois Medicaid Prior Authorization Annual Report 2025' (same fuf.aspx architecture as the California and Florida sibling filings). Percentages only. Figures with no corresponding schema field: expedited-request appeal overturn 69%; extended-timeframe requests approved 64% (standard) / 74% (expedited). Same verification caveat applies."
        },
        {
            "filing_id": "f0325",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Nebraska - Medicaid",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "NE",
            "reporting_period": "2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 13,
            "std_denial_rate_printed": 13,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 37,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 8,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 16,
            "exp_tat_median_hours": 17,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ne/medicaid/Claims/priorauth.aspx",
            "source_segment": "w3_plains",
            "extraction_note": "Published as an HTML table ('MHNE Medicaid') on the same provider prior-authorization page as the Molina Nebraska CHIP filing above; percentages only, no raw counts anywhere on the page, so reports_counts is false. Document also prints an expedited 'approved after appeal' figure of 45% for which the schema has no field; noted here rather than silently dropped."
        },
        {
            "filing_id": "f0340",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Marketplace South Carolina",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "SC",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 13,
            "std_denial_rate_printed": 13,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 50,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 10,
            "ext_review_approved": null,
            "std_tat_mean_days": 5,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 25,
            "exp_tat_median_hours": 23,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinamarketplace.com/marketplace/sc/en-us/Providers/Provider-Forms.aspx",
            "source_segment": "wave2",
            "extraction_note": "Percentages only. Entity named 'Molina Clinical Services, LLC' in the document; state attribution from page placement."
        },
        {
            "filing_id": "f0343",
            "parent_org": "Molina Healthcare",
            "plan_name": "Senior Whole Health of New York - MLTSS",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 13,
            "std_denial_rate_printed": 13,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 16,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 13,
            "ext_review_approved": null,
            "std_tat_mean_days": 3,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 79,
            "exp_tat_median_hours": 43,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; warn:expedited_slower_than_standard; info:percentages_only",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://www.molinahealthcare.com/providers/ny/swh/forms/prior-auth-reporting.aspx",
            "source_segment": "national",
            "extraction_note": "Percentages only. Mean expedited turnaround of 79 hours exceeds the 72-hour expedited standard."
        },
        {
            "filing_id": "f0329",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Ohio (Medicaid)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "OH",
            "reporting_period": "CY2025",
            "std_total": 68163,
            "std_approved": 59419,
            "std_denied": 8744,
            "std_denial_rate": 12.83,
            "std_denial_rate_printed": null,
            "std_appeals_total": 562,
            "std_appeals_overturned": 120,
            "std_appeal_overturn_rate": 21.35,
            "exp_total": 7439,
            "exp_approved": 6658,
            "exp_denied": 781,
            "exp_denial_rate": 10.5,
            "ext_review_approved": 0,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 0,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://dam.assets.ohio.gov/image/upload/medicaid.ohio.gov/Providers/Billing/PriorAuthorization/Managed_Care-FinalPDF.pdf",
            "source_segment": "states",
            "extraction_note": "Plan-level row in ODM's consolidated managed care filing."
        },
        {
            "filing_id": "f0317",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Clinical Services, LLC (Mississippi)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "MS",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 11.9,
            "std_denial_rate_printed": 11.9,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 20,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 9.62,
            "ext_review_approved": null,
            "std_tat_mean_days": 2.67,
            "std_tat_median_days": 3.1,
            "exp_tat_mean_hours": 14.84,
            "exp_tat_median_hours": 14.79,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ms/medicaid/forms/fuf.aspx",
            "source_segment": "w3_ky_nc_ms_ny",
            "extraction_note": "Molina Clinical Services, LLC is reported as a separate entity from Molina Healthcare of Mississippi, Inc. on the same page, described there as a delegated utilization-management entity; it is not clear whether this represents a distinct product/benefit line or a delegated UM subset of the same Mississippi Medicaid membership, so coverage_type is a best-fit guess - flagging for downstream review rather than omitting the data. Percentages only, no total counts published. Document's 'Extended timeframe' approval rate (61%) not stored (field expects a count, not a percentage)."
        },
        {
            "filing_id": "f0338",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Wisconsin - BadgerCare Plus",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "WI",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 10,
            "std_denial_rate_printed": 10,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 63,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 9,
            "ext_review_approved": null,
            "std_tat_mean_days": 5,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 25,
            "exp_tat_median_hours": 22,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/wi/medicaid/forms/fuf.aspx",
            "source_segment": "w3_gaps_a",
            "extraction_note": "Companion table to 'Molina Healthcare of Wisconsin - Medicaid SSI' on the same page, titled 'Medicaid BadgerCare Plus Prior Authorization Annual Report 2025'. Percentages only. Figures with no corresponding schema field: expedited-request appeal overturn 67%; extended-timeframe requests approved 80% (standard) / 89% (expedited). Same verification caveat applies."
        },
        {
            "filing_id": "f0341",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina MyCare Ohio",
            "contract_id": null,
            "coverage_type": "Medicare-Medicaid Plan",
            "state": "OH",
            "reporting_period": "CY2025",
            "std_total": 27660,
            "std_approved": 25122,
            "std_denied": 2538,
            "std_denial_rate": 9.18,
            "std_denial_rate_printed": null,
            "std_appeals_total": 386,
            "std_appeals_overturned": 157,
            "std_appeal_overturn_rate": 40.67,
            "exp_total": 2535,
            "exp_approved": 2232,
            "exp_denied": 303,
            "exp_denial_rate": 11.95,
            "ext_review_approved": 0,
            "std_tat_mean_days": 1,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": 0,
            "exp_tat_median_hours": 24,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://dam.assets.ohio.gov/image/upload/medicaid.ohio.gov/Providers/Billing/PriorAuthorization/MyCare_-_FInalPDF.pdf",
            "source_segment": "states",
            "extraction_note": "Median exceeds mean for both standard and expedited, as printed."
        },
        {
            "filing_id": "f0318",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Complete Care of Arizona (AHCCCS Medicaid)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "AZ",
            "reporting_period": "2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 9,
            "std_denial_rate_printed": 9,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 53,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 11,
            "ext_review_approved": null,
            "std_tat_mean_days": 6,
            "std_tat_median_days": 5,
            "exp_tat_mean_hours": 27,
            "exp_tat_median_hours": 21,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/az/medicaid/forms/fuf.aspx",
            "source_segment": "w3_west",
            "extraction_note": "Document titled 'MCCAZ Medicaid Prior Authorization Report 2025'; all values are whole-number percentages, no raw counts published (reports_counts=false). Document also prints 'extended timeframe approvals: 63%' (standard) and, for expedited, 'approved after appeal: 71%' and 'extended timeframe approvals: 61%' — none of which have matching schema fields (schema has no expedited-appeal or percentage-only ext-review slots) and are recorded here only. The standard and expedited appeal-overturn percentages (53% and 71%) are unusually high relative to other filings in this dataset and worth a second look; denominator (of denials, or of all appeals filed) is not stated in the document."
        },
        {
            "filing_id": "f0324",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Nebraska - CHIP",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "NE",
            "reporting_period": "2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 8,
            "std_denial_rate_printed": 8,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 33,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 7,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 19,
            "exp_tat_median_hours": 20,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ne/medicaid/Claims/priorauth.aspx",
            "source_segment": "w3_plains",
            "extraction_note": "Published as an HTML table ('MHNE CHIP Medicaid') on the provider prior-authorization page, not a standalone PDF; percentages only, no raw request counts given anywhere on the page, so reports_counts is false and no *_total/*_approved/*_denied counts are populated. Document also prints an expedited 'approved after appeal' figure of 50% for which the schema has no field (only std_appeal_overturn_pct exists); noted here rather than silently dropped."
        },
        {
            "filing_id": "f0344",
            "parent_org": "Molina Healthcare",
            "plan_name": "Senior Whole Health of New York - Medicare",
            "contract_id": "H5992",
            "coverage_type": "Medicare Advantage",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 8,
            "std_denial_rate_printed": 8,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 30,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 12,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 18,
            "exp_tat_median_hours": 17,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ny/swh/forms/prior-auth-reporting.aspx",
            "source_segment": "national",
            "extraction_note": "Percentages only, no counts or denominators."
        },
        {
            "filing_id": "f0339",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Wisconsin - Medicaid SSI",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "WI",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 7,
            "std_denial_rate_printed": 7,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 57,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 8,
            "ext_review_approved": null,
            "std_tat_mean_days": 6,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 29,
            "exp_tat_median_hours": 23,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/wi/medicaid/forms/fuf.aspx",
            "source_segment": "w3_gaps_a",
            "extraction_note": "Page carries two separate CMS-0057 tables for Wisconsin — this one titled 'Medicaid SSI Prior Authorization Annual Report 2025'; see the companion 'Molina Healthcare of Wisconsin - BadgerCare Plus' filing in this file for the other. Percentages only. Figures with no corresponding schema field: expedited-request appeal overturn 100%; extended-timeframe requests approved 92% (standard) / 78% (expedited). Same verification caveat as the other Molina filings in this file applies."
        },
        {
            "filing_id": "f0323",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Mississippi, Inc.",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "MS",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 6.7,
            "std_denial_rate_printed": 6.7,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 26.28,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 7.34,
            "ext_review_approved": null,
            "std_tat_mean_days": 3.03,
            "std_tat_median_days": 2.26,
            "exp_tat_mean_hours": 26.83,
            "exp_tat_median_hours": 23.61,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ms/medicaid/forms/fuf.aspx",
            "source_segment": "w3_ky_nc_ms_ny",
            "extraction_note": "Metrics are embedded directly in the HTML of this provider forms page under a 'SB 2140 Mississippi Prior Authorization Annual Reportings' heading (no separate PDF); percentages only, no total request counts published, so std_total/std_approved/std_denied/exp_total/exp_approved/exp_denied are null. Document also prints an 'Extended timeframe' approval rate of 57.22%, which is not stored because ext_review_approved is a count field in this schema, not a percentage. std_appeal_overturn_pct (26.28%) is labelled 'percentage of Prior Authorization requests that were Approved After an Appeal, aggregated for all items & services' - not split by standard/expedited in the source."
        },
        {
            "filing_id": "f0336",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas STAR+PLUS",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 6,
            "std_denial_rate_printed": 6,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 65,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 14,
            "ext_review_approved": null,
            "std_tat_mean_days": 3,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 52,
            "exp_tat_median_hours": 24,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Same source page as Molina TX STAR (separate table for STAR+PLUS). No raw counts, percentages only. Standard-track appeal-approval shown (65%); page separately prints an expedited appeal-approval figure of 69% with no schema field, noted here only."
        },
        {
            "filing_id": "f0327",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of New York Child Health Plus",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 5,
            "std_denial_rate_printed": 5,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 60,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 3,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 33,
            "exp_tat_median_hours": 28,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ny/medicaid/resource/utilized_mgt.aspx",
            "source_segment": "wave2",
            "extraction_note": "Rates only. Page labels this block 'CHP Medicaid (Marketplace)'; the label is ambiguous."
        },
        {
            "filing_id": "f0333",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas CHIP Perinate RSA (at or below 185% FPL)",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 5,
            "std_denial_rate_printed": 5,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 100,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 8,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 53,
            "exp_tat_median_hours": 37,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; warn:expedited_slower_than_standard; info:percentages_only",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Same source page, CHIP Perinate RSA (<=185% FPL) table. No raw counts, percentages only. Standard-track appeal-approval shown (100%); expedited appeal-approval separately printed at 67%, no schema field, noted here only."
        },
        {
            "filing_id": "f0321",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Idaho (Medicaid Plus)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "ID",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 4,
            "std_denial_rate_printed": 4,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 80,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": null,
            "ext_review_approved": null,
            "std_tat_mean_days": 1,
            "std_tat_median_days": 0,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/id/medicaid/forms/fuf.aspx",
            "source_segment": "wave2",
            "extraction_note": "Percentages only. All expedited metrics printed as 'NA'."
        },
        {
            "filing_id": "f0332",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of Texas CHIP Perinate MHT (at or below 185% FPL)",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "TX",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 4,
            "std_denial_rate_printed": 4,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": null,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 12,
            "ext_review_approved": null,
            "std_tat_mean_days": 1,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 59,
            "exp_tat_median_hours": 24,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; warn:expedited_slower_than_standard; info:percentages_only",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://www.molinahealthcare.com/providers/tx/medicaid/forms/PA.aspx",
            "source_segment": "w3_tx_south",
            "extraction_note": "Same source page, CHIP Perinate MHT (<=185% FPL) table. No raw counts, percentages only. No appeal-approval percentage was printed for this specific tier (appeal column blank/not applicable), so std_appeal_overturn_pct is omitted."
        },
        {
            "filing_id": "f0319",
            "parent_org": "Molina Healthcare",
            "plan_name": "Molina Healthcare of California (Medi-Cal)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "CA",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 2,
            "std_denial_rate_printed": 2,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 43,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 2,
            "ext_review_approved": null,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 16,
            "exp_tat_median_hours": 3,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.molinahealthcare.com/providers/ca/medicaid/forms/fuf.aspx",
            "source_segment": "w3_gaps_a",
            "extraction_note": "Table titled 'California Medicaid Prior Authorization Annual Report 2025' appears under a 'CMS-0057 Prior Authorization Annual Reporting' heading on Molina's California Medicaid 'Frequently Used Forms' page. This is the same URL pattern (/providers/{state}/medicaid/forms/fuf.aspx) that already produced Molina's captured Idaho and South Carolina filings, and the same page pattern was confirmed empty of any such table for Michigan and Texas, so the pattern reliably distinguishes presence from absence. Percentages only, no raw counts published. Figures printed on the page with no corresponding field in this schema: expedited-request appeal overturn 41%; extended-timeframe requests approved 72% (standard) / 74% (expedited). The page's table could not be dumped as raw HTML through this fetch tool despite repeated attempts (only model-summarized extractions were obtainable), so a future collector should re-verify directly against the live page if possible before treating this as final."
        },
        {
            "filing_id": "f0342",
            "parent_org": "Molina Healthcare",
            "plan_name": "Senior Whole Health of New York - FIDE",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "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": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": null,
            "ext_review_approved": null,
            "std_tat_mean_days": 5,
            "std_tat_median_days": 3,
            "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://www.molinahealthcare.com/providers/ny/swh/forms/prior-auth-reporting.aspx",
            "source_segment": "national",
            "extraction_note": "Percentages only; 100% approval reported."
        }
    ]
}