Filing · f0249

Hamaspik Choice (MLTC)

Hamaspik · Medicaid Managed Care · NY · CY2025

This plan reported a 49.0% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicaid Managed Care plans of comparable size is 13.2%. 3 checks flagged this filing.

Standard denial rate
49.0%
This filing published percentages without counts. 15.0% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 49.0%
Expedited 16.0%

This payer also printed its own standard denial rate: 49.0%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate15.0%

This filing publishes no appeal outcome. CMS-0057-F does not require one.

Turnaround
MeanMedian
Standard7.6 d4.3 d
Expedited101.3 h61.4 h
What the checks found
warnhigh_denial_rate

49% standard denial rate is far above the peer range

infoappeals_not_reported

no appeal outcome data published

infopercentages_only

filing publishes percentages without underlying counts; arithmetic cannot be verified