"Not Medically Necessary": Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care
Summary
ProPublica's investigative report exposes how health insurers outsource prior authorizations to EviCore, a cost-cutting intermediary, using algorithms to deny care and generate revenue. The piece documents the potential conflict of interest, the 'denials-for-dollars' model, and the human impact—patients delayed or denied essential procedures, with regulatory and legal scrutiny highlighted.