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Cited authority · 2021-2025 · California

American College of Obstetricians and Gynecologists

Independent medical reviewers in California named American College of Obstetricians and Gynecologists in 59 published decisions over 2021-2025. These are the disputes it turned up in.

32.2%

Overturned
19 of 59
Era
2021-2025
Jurisdiction
California DMHC IMR
19 overturned40 upheld

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 standard

  • against the market

    Decisions naming American College of Obstetricians and Gynecologists came out at 32.2%, 33 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.

  • where it is used

    It appears most in diagnostic imaging & screening disputes — 33 of the 59 decisions citing it, 56% of its whole footprint, at 15.2%.

Treatment classes

computed
  • Diagnostic imaging & screening15.2%33
  • Pharmacy—9
  • OB-GYN procedures—8
  • Diagnostic & physician evaluation—3
  • Electro, thermal & radiofrequency—3
  • Durable medical equipment—1

Condition classes

computed
  • Genitourinary & kidney—27
  • Pregnancy/Childbirth—20
  • Infectious disease—4
  • Endocrine & metabolic—2
  • Mental health—2
  • Prevention & wellness—2