2025 Prior Authorization Metrics
CMS-required data on prior authorizations from 2025
Standard (non-urgent) authorization request approvals
In 2025 we received a total of 418,557 standard (non-urgent) prior authorization requests for our covered patients. 98% of those requests were approved.
The mean (average) time that it took to make standard prior authorization decisions once the request was entered into the Medicaid Management Information System was 1 day.
The median (middle) time that it took to make standard prior authorization decisions once the request was entered into the Medicaid Management Information System was 1 day.
Expedited (urgent) authorization requests for covered patients in 2025
In 2025 we received a total of 104,477 expedited (urgent) prior authorization requests for our covered patients. 99% of those requests were approved,
The mean (average) time that it took to make standard prior authorization decisions once the request was entered into the Medicaid Management Information System was 1 day.
The median (middle) time that it took to make standard prior authorization decisions once the request was entered into the Medicaid Management Information System was 1 day.
All authorizations in 2025
Standard Service Authorization Requests in 2025
|
Total |
Instances |
Total Requests |
Percentage |
|---|---|---|---|
|
Approved |
421,217 |
430,236 |
97.90% |
|
Denied |
9,019 |
430,236 |
2.10% |
Expedited Service Authorization Requests in 2025
|
Total |
Instance |
Total Requests |
Percentages |
|---|---|---|---|
|
Approved |
105,009 |
106,213 |
98.87% |
|
Denied |
1,204 |
106,213 |
1.13% |
Subsets of all authorizations in 2025
Standard Service Authorization Requests in 2025
|
Total |
Instances |
Total Requests |
Percentage |
|---|---|---|---|
|
Approved After Appeal |
13 |
34 |
38.24% |
|
Denied After Appeal |
21 |
34 |
61.76% |
|
Approved Within 7 Days |
414,180 |
419,135 |
98.82% |
|
Denied Within 7 Days |
4,955 |
419,135 |
1.18% |
|
Approved After 7 Days |
7,024 |
11,067 |
63.47% |
|
Denied After 7 Days |
4,043 |
11,067 |
36.53% |
Expedited Service Authorization Requests in 2025
|
Total |
Instances |
Total Requests |
Percentage |
|---|---|---|---|
|
Approved After Appeal |
- |
- |
0% |
|
Denied After Appeal |
- |
- |
0% |
|
Approved Within 7 Days |
104,723 |
105,804 |
98.82% |
|
Denied Within 7 Days |
1,081 |
105,804 |
1.18% |
|
Approved After 7 Days |
286 |
409 |
69.93% |
|
Denied After 7 Days |
123 |
409 |
30.07% |
Alaska operates entirely within a single FFS (Fee-For-Service) program. Thus, all the Service Authorizations pertaining to covered Alaskan Medicaid Recipients are reported above.
- Service Authorizations have been aggregated from the following sources:
- Division of Health Care Services (HCS)
- Division of Senior and Disabilities Services (SDS)
- Division of Behavioral Health (DBH)
- Comagine Health*
*The contractor Comagine Health provides service authorizations for some requests under HCS and DBH