Massachusetts external-review reversal rate

40.0%

Reported for 2023 · State-reported

Administered by Massachusetts Office of Patient Protection (OPP) at Health Policy Commission. This is one cell of a 50-state public-record dataset; across measured jurisdictions the reported rate ranges from 17.0% (West Virginia) to 80.0% (Connecticut).

Read this number carefully

~40% of OPP external reviews resolved in patient's favor per OPP 2023 Annual Report referenced by MA HPC. 2024 report not yet located; flag as most-recent-published is 2023.

Denominators are not comparable between jurisdictions. Some states count cases received, some completed, some completed-and-eligible; some publish a complaint-process reversal rate broader than IRO-only external review. We reproduce the figure exactly as the jurisdiction published it and do not extrapolate.

Official sources

The administering authority is Massachusetts Office of Patient Protection (OPP) at Health Policy Commission. We could not machine-verify a stable public URL for this jurisdiction's external-review statistics at build time, so no source link is shown here rather than risk pointing you at a broken address. The underlying citation is recorded in the CSV and methodology.

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Apellica (2026). The Apellica External Review Index — Massachusetts. v1.0. Released 2026-05-19; resource updated 2026-09-04. CC-BY-4.0. https://apellica.com/external-review-index/massachusetts

Spot an error in this figure or its source? Email editorial@apellica.com with the jurisdiction, the value you believe is correct, and a public-record URL. Apellica is an independent appeal-preparation service — not a regulator, law firm, or insurer — publishing this public regulatory data as a free research resource.