Calendar Year 2025 Prior Authorization Metrics (program not named in document)
Commonwealth of Massachusetts · Medicaid FFS · MA · CY2025
This plan reported a 14.6% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicaid FFS plans of comparable size is 7.4%. 2 checks flagged this filing.
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | — | — | — | 14.6% |
| Expedited | — | — | — | 21.8% |
This payer also printed its own standard denial rate: 14.6%. The rate above is computed from the published counts, so the two can be compared.
| Appeals filed | — |
| Denials overturned | — |
| Overturn rate | 29.5% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
| Mean | Median | |
|---|---|---|
| Standard | 4.2 d | 2.0 d |
| Expedited | 32.0 h | 2.0 h |
no appeal outcome data published
filing publishes percentages without underlying counts; arithmetic cannot be verified