"Not Medically Necessary": Helping America's Health Insurers Deny Coverage

propublica.org
May 13, 2026
20 min read
58/100
Summary
Reporting Highlights - Dialing for Dollars: America’s largest insurers hire EviCore to make decisions on whether to pay for care for more than 100 million people. - “The Dial”: EviCore uses an algorithm that allows it to adjust the chances that company doctors will screen prior authorization requests, increasing the possibility of denials. - Lucrative Deals: Some EviCore contracts are based on how...
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