Preauthorization Benchmark Attainment

Online preauthorization systems are fairly similar across payors and PBMs, providing about the same functionality. Payor and PBM outreach initiatives have resulted in a modest volume of electronic preauthorization requests. Payors report around 18 percent of medical service preauthorization requests are submitted electronically. Pharmacy preauthorization requests submitted electronically are more disappointing; less than two percent are submitted via online processes. The MHCC is required to provide annual reports to the Governor and General Assembly on payor and PBM progress in meeting the law through December 31, 2016.

Click here to download the report.