Filing · f0294

Kaiser Mid-Atlantic States - Maryland Medicaid

Kaiser Permanente · Medicaid Managed Care · MD · 13202 · CY2025

This plan reported a 7.1% 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%.

Standard denial rate

7.1%

This filing published percentages without counts. 31.4% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	—	14,541	1,028	7.1%
Expedited	—	—	—	—
Extended review, approved	0

This payer also printed its own standard denial rate: 7.1%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials

Appeals filed	35
Denials overturned	11
Overturn rate	31.4%

Turnaround

	Mean	Median
Standard	1.0 d	0.5 d
Expedited	—	—

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%