Policy Details

HB2175 – Prior Authorization; Claims

Date Passed

5/12/2025

Effective Date

6/30/2026

Summary

Prohibits use of artificial intelligence to deny a claim or prior authorization and requires an Arizona-licensed healthcare provider to individually review any denial involving medical judgment; denial without such review is unprofessional conduct.

Healthcare Implications

Eliminates AI-only utilization management denials and forces human clinical review before adverse decisions, impacting payer workflows and any vendor rules engines; expect documentation and appeal handling changes, with oversight implications for regulators and providers.

Impact Level

High

Keywords

Safety & Risk; Transparency & Governance

Stakeholders

Payers & Purchasers; Providers & Health Systems; Regulators & Government