GAO: Some Carriers Say "Yes" More Often Than Others

found that the reviewers in those states often reverse denials when consumers file appeals.

Figures from 4 of the 6 states indicated that 39% to 59% of the appeals resulted in reversals, officials say.

Researchers who conducted a similar study for an insurance company trade association found that, in states with an independent external review system, the reviewers reversed claim denials about 40% of the time.

A provision in the Patient Protection and Affordable Care Act (PPACA) required the GAO to do the denial study.

GAO officials warn that they found little information about the reasons for variations in application denial rates.

"There are also several issues to consider when interpreting application denial rates," officials say. An individual who faced an application denial may have succeeded at getting coverage from the carrier by agreeing to pay a non-standard rate, and some individuals who were rejected may have secured coverage from other carriers, officials say.

HHS officials say they agree with the GAO's findings and would like to improve the quality and scope of denial data.

Other GAO coverage from National Underwriter Life & Health:

• GAO to Labor: Tighten 401(k) Plan Securities Rules
• GAO: Brand-Name Drug Prices Rise as Generic Prices Fall
• GAO: Bundling Easier Said than Done
• GAO: Plan Fiduciaries Should Give Better Warnings
• GAO Backs Target Date Fund Disclosure Changes