Section 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 the effective date of this title.(2) The following information shall be made available to an enrollee: (A) A copy of all information or materials submitted by the enrollee's health care provider in support of a request for approval or reauthorization, or an appeal from an adverse determination, which shall clearly show the date the information or materials were submitted, the health care service prescribed by the health care provider, and the reason, if any, provided by the health care provider in requesting the health care service; and(B) A copy of all notices of determination provided to the enrollee issued pursuant to section 103 of this title.(b) Beginning January 1, 2025, a utilization review entity shall make publicly available on its website in a readily accessible format statistics regarding approvals, adverse determinations, and appeals, including information on the: (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.(c) [Not funded.] This section shall not apply to information pertaining to long-term services and supports.Added by D.C. Law 25-100,§ I-109, 70 DCR 015238, eff. 1/17/2024.Sec. 301(a) of the 2024 enacting legislation provides that "Sections 101(5), (10)(C), and (D), 102(a)(2)(A)(i) and (ii), 103(a)(2), 104(b)(2), and 109(c) shall apply upon the date of inclusion of its fiscal effect in an approved budget and financial plan."