The percentage of prior authorization requests that are not approved, now subject to public reporting requirements for many payers.
What it means
Under CMS-0057-F, impacted payers must publicly report denial rate metrics annually, making a number that was once internal-only visible to regulators, employers, and members. This shifts denial rate from a quiet operational metric into something with reputational weight, and increases pressure on payers to work with tools that improve accuracy on the front end rather than manage denials after the fact.
