{
    "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": "f0610",
            "parent_org": "VillageCare",
            "plan_name": "VillageCareMAX Managed Long-Term Care",
            "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": 62.3,
            "std_denial_rate_printed": 62.3,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 4.3,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 46.6,
            "ext_review_approved": null,
            "std_tat_mean_days": 7.28,
            "std_tat_median_days": 5,
            "exp_tat_mean_hours": 92.64,
            "exp_tat_median_hours": 24,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; warn:high_denial_rate; info:percentages_only",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://www.villagecaremax.org/prior-authorizations-reporting",
            "source_segment": "ca_ny",
            "extraction_note": "HIGHEST DENIAL RATE IN THE DATASET: 62.3% standard, 46.6% expedited. Only 4.3% of appeals overturned. Expedited mean of 3.86 days (92.6h) far exceeds any expedited standard. Percentages only, no counts to check against.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "mcd:NY:villagecaremax",
            "filing_unit": "medicaid_plan"
        },
        {
            "filing_id": "f0612",
            "parent_org": "VillageCare",
            "plan_name": "VillageCareMAX Total Advantage (D-SNP) - Medicaid requests",
            "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": 28.6,
            "std_denial_rate_printed": 28.6,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 13.5,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 15.7,
            "ext_review_approved": null,
            "std_tat_mean_days": 4.84,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 20.88,
            "exp_tat_median_hours": 0,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.villagecaremax.org/prior-authorizations-reporting",
            "source_segment": "ca_ny",
            "extraction_note": "Percentages only. Expedited TAT converted days->hours.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "mcd:NY:villagecaremax",
            "filing_unit": "medicaid_plan"
        },
        {
            "filing_id": "f0611",
            "parent_org": "VillageCare",
            "plan_name": "VillageCareMAX Medicare (all plans, aggregated)",
            "contract_id": null,
            "coverage_type": "Medicare Advantage",
            "state": "NY",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 17.8,
            "std_denial_rate_printed": 17.8,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 32.9,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 3.5,
            "ext_review_approved": null,
            "std_tat_mean_days": 6.53,
            "std_tat_median_days": 5,
            "exp_tat_mean_hours": 17.76,
            "exp_tat_median_hours": 0,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.villagecaremax.org/prior-authorizations-reporting",
            "source_segment": "ca_ny",
            "extraction_note": "Percentages only. Expedited TAT converted days->hours.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "ma:H2168",
            "filing_unit": "ma_contract"
        }
    ]
}