State coverage · all states
Texas does not run its own external review process
No rate is shown for Texas, because this dataset holds no Texas decisions. California's numbers are California's and do not transfer.
What was found
verified 2026-09-04- External review process
- No state process. Appeals go to the external review administered for the federal Department of Health and Human Services.
- What is published
- Independent review decisions are published for workers' compensation only, CY2018 onward
- What that means
- Three of the ten largest markets do not run a state external review process at all, and this is one. ACA external appeals go to the federal process, which publishes nothing. The workers' compensation decisions are a different system with different numbers; blending them would be fabricating.
What is true in every state. A federal right to an external review of most denials exists regardless of where you live, and your state’s insurance regulator or consumer-assistance program can tell you the route and the deadline for free. If your plan is a self-funded employer plan, that appeal goes to the federal process wherever you are — and that process publishes no decisions, so nothing here or anywhere describes its outcomes. Whether this covers you.