If you didn't catch this when it dropped last year, this unfortunately is not a new thing. As someone who works in medicine, none of this surprises me, and this space desperately needs regulation. A proper gold standard might be regulation which forces all insurance companies to use a 3rd party (perhaps run by the government) review body for appeals at a certain step (clinician review). Even if we didn't use a 3rd party for appeals and instead had regular review of denial rates and compared insurers to each other by diagnosis, cpt code, etc. that would be significantly preferred to the current state of affairs. Until then, I don't see anything happening out of capitalism except for denials to continue to grow for all insurers over time and for the denial appeal to become a more regular part of everyone's healthcare.

Why are they even allowed to use their own doctors to decide if they will cover the treatment? That is an obvious conflict of interest going on there.