AZ HB2471

Establishes standardized health care appeal processes with defined timelines for members to challenge insurance denials, including expedited reviews for urgent medical situations and external independent reviews for unresolved disputes.

Creates new drug formulary exception request procedures allowing members to request coverage of non-covered medications through standard (72-hour) or expedited (24-hour) processes, with external review available if initial requests are denied.

Requires health care insurers to provide detailed written information about appeal and exception request processes, including contact information and procedures, and to prominently display this information on their websites.

Modifies terminology throughout the appeals process (changing "adverse decision" to "adverse determination" and "informal reconsideration" to "initial appeal") and restructures internal review levels to include expedited medical review, initial appeal, and optional voluntary internal appeal for group plans.

Requires health care insurers to maintain records of all appeals and exception requests for at least six years and authorizes the Director of Insurance to assess insurers up to $200 annually to fund external independent review operations.