Treatment class · subcategory · California
Liposuction denials at external review
When a California health plan denied care in the liposuction class and the enrollee took it to Independent Medical Review, this is what independent physician reviewers decided.
35.1%
- Overturned
- 13 of 37
- Era
- 2021-2025
- Jurisdiction
- California DMHC IMR
- Published class
- Liposuction
- Median days to decision
- 50
- All years
- 39.1% of 87
Authorities named in this class
computed- American Society of Plastic Surgeons—3
- FDA—1
- WPATH—1
A rate here is the outcome of decisions that named the authority, not the effect of naming it. Reviewers cite the standard they applied; the citation and the outcome share a cause.
By condition
computed- Overturned — the reviewer did not sustain the denial
- Upheld — the reviewer sustained the denial
- Endocrine & metabolic—28
- Skin—4
- Mental health—2
- Orthopedic & musculoskeletal—2
- Trauma & injuries—1
The specific conditions inside this class
below n=30, no rate is claimed- Lipedema (Lipoedema)—19
- Other—8
- Obesity—4
- Excess Skin—2
- Gender Dysphoria—2
- Deformities—1
- Gynecomastia—1
Every figure on this page is conditional on a denial having reached external review. Fewer than 1% of denials are appealed internally at all, so this describes denials that were fought to the end — not denials in general — and it describes California only. Who this does not cover.
Free help, first: the California DMHC Help Center files your Independent Medical Review at no cost — 1-888-466-2219, dmhc.ca.gov.