Learn more about new federal Medicaid changes.
To comply with the CMS Interoperability and Prior Authorization final rule, Hennepin Health is required to annually report aggregated prior authorization metrics on our website. Specifically, this includes a list of all medical items and services (excluding drugs) that require prior authorization, as well as data on prior authorization requests for those items and services (e.g., approvals, denials, etc.) over the previous calendar year. Publicly reporting these metrics promotes transparency and accountability, helps patients understand prior authorization processes, and enables providers to evaluate payer performance. In addition, metrics can be used to compare plans, programs, and payers. For questions on the data below, call the Hennepin Health Member Services at 612-596-1036, TTY 711.
These are the medical items and services for which we require prior authorization (excluding drugs): prior-authorization-chart.pdf (PDF, 1MB)
Prior to January 1, 2026, Hennepin Health was required to send prior authorization decisions within the following timeframes:
Beginning January 1, 2026, the CMS Interoperability and Prior Authorization final rule requires Hennepin Health to send prior authorization decisions within:
DHS approved 3/25/26; ID# UM-1911-MM