Filing · f0379
Mass General Brigham Health Plan - MGB ACO (MassHealth)
Mass General Brigham · Medicaid Managed Care · MA · CY2025
In 2025 this plan received 41,373 standard prior authorization requests and denied 10.1% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
10.1%
41,373 standard requests, 4,193 denied.
24.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 41,373 | 37,180 | 4,193 | 10.1% |
| Expedited | 9,489 | 9,170 | 319 | 3.4% |
| Extended review, approved | 1 | |||
Appeals of standard denials
| Appeals filed | 208 |
| Denials overturned | 51 |
| Overturn rate | 24.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.2 d | 1.4 d |
| Expedited | 55.0 h | 29.0 h |