Arizona: AI health laws

HB 2175, Prior Authorization; Claims

Requires a health care insurer's medical director to individually review, before it is issued, any denial of a provider-submitted claim on the basis of medical necessity and any direct denial of a provider's prior authorization request that involves medical necessity, exercising independent medical judgment and not relying solely on recommendations from any other source.

Physician read. Since July 1, 2026, before a health care insurer denies a claim a physician or other provider submitted on the basis of medical necessity, or directly denies a provider's prior authorization request that involves medical necessity, its medical director must individually review the denial, exercise independent medical judgment and not rely solely on recommendations from any other source. The enacted law does not mention artificial intelligence; an explicit ban on using AI to deny claims or prior authorizations appeared in the House version but not in the law as signed.

Applies to: Health care insurers regulated under Arizona Revised Statutes Title 20

Notes: Approved by the Governor and filed with the Secretary of State May 12, 2025; effective from and after June 30, 2026. Amends A.R.S. Sections 20-3103 (claims) and 20-3407 (prior authorization). The act does not define 'medical director' or 'direct denial.' The enacted text does not use the term 'artificial intelligence.' The House-passed version provided that AI 'may not be used to deny a claim or a prior authorization for medical necessity, experimental status or any other reason that involves the use of medical judgment' and required a health care provider to individually review each such claim or prior authorization; the Senate Finance Committee adopted a strike-everything amendment March 17, 2025, and the enacted text instead requires the medical director's individual review, independent medical judgment and no sole reliance on recommendations from any other source.