State Detail
Oregon
1 plan reporting · CY 2024
Across 1 plan reporting in Oregon, standard prior authorization denial rates range from 4.2% to 4.2%, averaging 4.2%. Among plans reporting appeal outcomes, 39.5% of appealed denials are overturned. All data is from mandatory CMS-0057-F disclosures for calendar year 2025.
Plan Comparison
| Standard | Expedited | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Plan | Org | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Requests | Approved | Denied | Appr % | Denial % | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
| Oregon Health Authority | ||||||||||||||||||||||||||
| Oregon CCO Aggregate (All Coordinated Care Organizations)Medicaid MCO | Oregon Health Authority | 1,466,821 | 1,405,150 | 61,671 | 95.8% | 4.2% | — | 39.5% | 60.5% | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | View source ↗ |
Standard Denial Rates by Plan
Appeals Analysis
Plans in the upper-right deny frequently and have high overturn rates — suggesting inappropriate denials.
Similar Denial Rates