Cited authority · 2021-2025 · California
American Academy of Pediatrics
Independent medical reviewers in California named American Academy of Pediatrics in 43 published decisions over 2021-2025. These are the disputes it turned up in.
58.1%
- Overturned
- 25 of 43
- Era
- 2021-2025
- Jurisdiction
- California DMHC IMR
What this number is, and is not. It is the outcome of decisions in which the authority was named — not the effect of naming it. Reviewers cite the standard they applied, so the citation and the outcome share a cause. Read it as “disputes where this standard was the yardstick came out this way”, never as “citing this standard produces this result”.
These count only denials appealed all the way to independent review. Fewer than 1% of denials are appealed internally at all, so a share here is not the share of denials that are wrong — it is the share of contested ones reviewers did not sustain. California only, and only plans the state regulates: not self-funded employer plans, Medicare or Medicaid.
Free help. The California DMHC Help Center files an Independent Medical Review at no cost — 1-888-466-2219, dmhc.ca.gov. It is the same review these decisions came from, and you do not need us or a lawyer to reach it.
What stands out here
computed from this standardagainst the market
Decisions naming American Academy of Pediatrics came out at 58.1%, 7 points below the 65.2% across all published decisions in this era. Reviewers reach for a standard when it settles the question, so the citation and the outcome share a cause.
Treatment classes
computed- Autism-related treatment—18
- Pharmacy—8
- Outpatient rehabilitation—7
- Durable medical equipment—2
- Home Health Care—2
- OB-GYN procedures—2
Condition classes
computed- Autism spectrum—22
- Pediatrics—6
- Endocrine & metabolic—4
- Respiratory—3
- Mental health—2
- Pregnancy/Childbirth—2