Arizona passes bill requiring independent review of prior auth, claims denials

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Arizona lawmakers have passed legislation that mandates health insurers to have a medical director independently review all claims denials based on medical necessity. 

The bill, passed May 6, requires the medical director to exercise independent medical judgment and bans relying solely on external recommendations during the review process, such as artificial intelligence tools.

Under the new law, insurers will also be required to undergo similar reviews before denying prior authorization for services that involve medical necessity. 

If signed by the governor, the legislation is set to become effective on June 30, 2026.

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