Law / United States / Arizona
Denial of claims; individualized review requirement
A citation is an address, not a summary. The first part names the law; what follows narrows it to the exact section, article or paragraph.
In force 77 days, effective 1 July 2026.
An AI sector rules rule binding private bodies.
As of 6 September 2026.
What it requires
- If you are a health care insurer, do not deny a claim submitted by a provider on the basis of medical necessity without a medical director individually reviewing the denial and exercising independent medical judgment.
- The reviewing medical director may not rely solely on recommendations from any other source, including an automated or AI-assisted recommendation, in making that individualized review.
What this law does
Drafted with AI from the cited sources under the direction of UnGovr staff. UnGovr holds editorial responsibility for this page.
Before a health care insurer may deny a claim submitted by a provider on the basis of medical necessity, a medical director must individually review the denial, exercise independent medical judgment, and may not rely solely on recommendations from any other source.
The section's own text and the Arizona Senate's fact sheet for the enacting bill, HB 2175 (2025), state this duty in technology-neutral terms; neither document uses the term artificial intelligence, though contemporaneous news coverage of the bill's passage describes it as a response to insurers' use of AI and algorithm-based tools to automate medical-necessity and prior-authorization denials. Enacted in 2025 as HB 2175, with the codified section itself noting an effective date of July 1, 2026.
When LexLint raises it
high_risk_decisions
Read the law
official Arizona Revised Statutes text, Arizona State Legislature website