California is forcing insurers to pay for medically dubious gender procedures through an appeals process which a former insider says has become corrupted for ideological reasons. The tactic centers on the Independent Medical Review Board, which allows individuals to appeal insurance denials and the decisions of which are binding. The medical review board overturned the denial, which means the insurance company was required to pay for it. The medical review board is also compromised, as some of its members specialize in “transgender health.” Renee Chiea used to work for the Department of Managed Health Care, which includes the insurance review board.