By Jonathan Eberle |
Health insurers in Arizona will soon be required to involve a licensed physician before denying medically necessary care, under a new law aimed at increasing oversight and accountability in coverage decisions. House Bill 2175, introduced by Republican House Majority Whip Julie Willoughby (R-LD13), was signed into law after receiving strong bipartisan support in the state legislature.
The legislation mandates that an Arizona-licensed medical director must personally review any denial based on medical necessity, whether it involves a prior authorization or a claim. Crucially, the reviewing physician must exercise independent medical judgment and cannot rely solely on automated tools or artificial intelligence systems.
“This law ensures that a doctor, not a computer, is making medical decisions,” said Willoughby in a statement. “If care is denied, it should be by someone with the training and ethical duty to put patients first.”
The law is set to take effect on July 1, 2026, allowing insurers more than a year to adapt their internal procedures. The delayed implementation aims to give companies time to bring their policies into compliance, including staffing licensed physicians for the review process.
The measure comes amid growing national scrutiny over how insurers use algorithms and automated decision-making tools in the claims process. Critics argue that such systems can lead to denials of care without adequate clinical oversight, potentially putting patient health at risk.
Supporters of HB 2175 say the law provides a necessary check on those systems and re-centers medical decision-making around qualified professionals who are accountable to both patients and state standards.
“Arizona families deserve real oversight when it comes to life-changing medical decisions,” Willoughby said. “This law puts patients ahead of profits and restores a layer of accountability that’s long overdue.”
The new policy aligns with the House Republican Majority Plan, which emphasizes individual rights and system transparency. While the law’s primary sponsors are Republican, it passed with bipartisan support, reflecting broad legislative agreement on the need for more oversight in insurance determinations.
The implementation of HB 2175 will be closely watched by healthcare advocates, insurers, and policy analysts as Arizona becomes one of the latest states to regulate the use of AI in healthcare decision-making.
Jonathan Eberle is a reporter for AZ Free News. You can send him news tips using this link.
