Analysis reveals independent medical review overturned 50% of health plan coverage denials, indicating variability in cancer genetic testing outcomes.
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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Lin et al. (2025) studied this question.
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