Filing · f0293

Kaiser Foundation Health Plan of the Northwest - Oregon Medicaid

Kaiser Permanente · Medicaid Managed Care · OR · CY2025

In 2025 this plan received 12,578 standard prior authorization requests and denied 20.4% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.

Standard denial rate

20.4%

12,578 standard requests, 2,569 denied. 20.0% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	12,578	10,009	2,569	20.4%
Expedited	365	288	77	21.1%

Appeals of standard denials

Appeals filed	185
Denials overturned	37
Overturn rate	20.0%

Turnaround

	Mean	Median
Standard	6.4 d	3.9 d
Expedited	25.0 h	5.0 h

Kaiser Foundation Health Plan of Washington	6.1%
Kaiser Permanente Northern California	10.5%
Kaiser Permanente Southern California	19.5%
Kaiser Foundation Health Plan of the Mid-Atlantic States	5.5%
Kaiser Foundation Health Plan of Colorado	9.6%
Kaiser Foundation Health Plan of the Northwest	12.6%
Kaiser Permanente Southern California - Medi-Cal	6.4%
Kaiser Foundation Health Plan of Georgia	3.1%