Filing · f0299

Kaiser Permanente Northern California - Medi-Cal

Kaiser Permanente · Medicaid Managed Care · CA · CY2025

In 2025 this plan received 24,982 standard prior authorization requests and denied 9.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.

Standard denial rate

9.0%

24,982 standard requests, 2,235 denied. 30.9% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	24,982	22,747	2,235	9.0%
Expedited	9,581	8,963	618	6.5%
Extended review, approved	71

Appeals of standard denials

Appeals filed	359
Denials overturned	111
Overturn rate	30.9%

Turnaround

	Mean	Median
Standard	1.3 d	0.9 d
Expedited	26.0 h	21.0 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%