AZ HB2175

Requires health care insurers' medical directors to individually review all claim denials based on medical necessity before denial is issued.

Mandates that medical directors exercise independent medical judgment during individual reviews and cannot rely solely on recommendations from other sources.

Requires health care insurers' medical directors to individually review all prior authorization denials involving medical necessity before issuing a direct denial.

Applies the same independent medical judgment standard to prior authorization reviews, prohibiting reliance solely on recommendations from other sources.

Effective date: June 30, 2026.