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Use Of Independent Medical Review: Almost One-Half Of Coverage Denials Overturned
Grace A Lin1, Janet M Coffman2, Michael P Douglas3
1Grace A. Lin (grace.lin@ucsf.edu), University of California San Francisco, San Francisco, California.
None:
Independent medical review is an important, underused source of data to illuminate the insurance coverage landscape. During the period 2019-23, almost one-half of health plan coverage denials that were appealed to independent medical review in four states were overturned. One-third of cancer genetic testing denials were overturned, with variation by state, cancer, and test.
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