Transparency Requirements

District of Columbia Prior Authorization Requirements

A guide to prior authorization rules, turnaround times, and laws for medical practices operating in District of Columbia (DC).

PA Turnaround Times

Standard Requests

14 calendar days

Urgent / Expedited

48 hours

Key Regulations

  • Standard PA turnaround of 14 calendar days
  • Urgent requests within 48 hours
  • PA criteria disclosure requirements

District of Columbia Medicaid PA

DC Medicaid uses managed care. PA administered by MCOs under District oversight.

Top Payers in District of Columbia

CareFirst Blue Cross Blue ShieldUnitedHealthcareAetnaKaiser Permanente

State Regulatory Body: DC Department of Insurance, Securities and Banking

File PA complaints or appeals through your state insurance department.

Automate PA in District of Columbia

Greenlight knows every payer's PA requirements in District of Columbia and checks them automatically before every appointment -- so your staff does not have to.

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