Evidence file · prior-authorization-humana-fl-fl-state-medicaid-2025

Humana

FL (state Medicaid) · Medicaid · 2025 · Florida

The takeaway

What this record says—and what it does not

This Medicaid reporting unit denied 2.6 of every 100 standard prior-authorization requests in 2025.

Compared with what?
That is below the 10.9% median among 9 records in this library with the same program, year, and metric. This is a directional comparison, not a quality grade.
How could I use this?
Use it to ask the payer about its review process, compare like reporting units, or identify a pattern worth deeper reporting, research, or regulatory review.
What can’t I conclude?
It is an aggregate rate. It does not identify a service, explain a particular decision, prove that a denial was wrongful, or describe a different plan or program.
Standard requests
746,974 count
Standard requests denied
2.56%
Standard requests denied
19,097 count
Appeals
2,499 count
Appeals overturned
7.6%
Expedited requests
9,365 count
Expedited requests denied
40.86%

Scope and limits

Family
prior-authorization
Scope
Contract-level CMS-0057-F prior authorization disclosure
Status
published
Missing fields
None identified in normalized fields

Artifact and version

Captured
2026-07-17T21:57:18.384Z
SHA-256
896c40ab47e811f03dee602c6fb27e49814faf315abfdb95192f38ed443582da
Version
896c40ab47e8
Extraction
Parsed from the checked source extraction and normalized by pipeline v1.

Citation and files

Humana FL (state Medicaid), CMS-0057-F prior authorization metrics, plan year 2025.

Open original source ↗ · Download the preserved copy

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