In California, these doctors are not required to be licensed within the state, and have the power to veto any diagnostic or treatment plan by a patient’s primary physician.
Worse, they cannot be disciplined:
A huge snag in the system is that utilization review doctors without California licenses cannot be disciplined by the Medical Board of California for unprofessional conduct because they aren’t under board jurisdiction. Neither can they be prosecuted in the states in which they do have licenses, because those states don’t have jurisdiction in California.
These hired guns have a huge say in treatment and diagnostic decisions, and cannot be held accountable.
What a scam.