District of Columbia Code Division V. Local Business Affairs § 31-3875.09. Data transparency.

(a)(1) Beginning January 1, 2025, a utilization review entity shall make available on its website, or by phone upon request, to an enrollee, representative, and health care provider, the information required by paragraph (2) of this subsection regarding the enrollee's active prior authorization requests made to that utilization review entity in at least the preceding 5 years; provided that, this paragraph shall not apply to a prior authorization request made before January 17, 2024.

(2) The following information shall be made available to an enrollee:

(1) Specialties of physicians reviewing prior authorization requests or appeals;

(2) Types of medication, tests, procedures, or treatment in which approval was being sought;

(3) Medical indication offered in each request;

(4) Reasons for an adverse determination;

(5) Number of appeals taken;

(6) Number of appeals approved or denied;

(7) Time between submission of a request and the utilization review entity's determination; and

(8) Time between submission of an appeal and the utilization review entity's determination.