Filing · f0302

Kaiser Permanente Southern California - Medi-Cal

Kaiser Permanente · Medicaid Managed Care · CA · CY2025

In 2025 this plan received 56,689 standard prior authorization requests and denied 6.4% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.

Standard denial rate

6.4%

56,689 standard requests, 3,622 denied. 24.4% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	56,689	53,067	3,622	6.4%
Expedited	7,722	7,523	199	2.6%
Extended review, approved	0

Appeals of standard denials

Appeals filed	234
Denials overturned	57
Overturn rate	24.4%

Turnaround

	Mean	Median
Standard	1.9 d	0.8 d
Expedited	4.0 h	0.0 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 Foundation Health Plan of Georgia	3.1%
Kaiser Permanente Northern California (H8794)	11.3%