Arizona HB 2175 — Physician Review Required Before AI-Based Health Insurance Denial

Arizona HB 2175 requires health insurers and managed-care organizations to have a licensed physician or medical director individually review each case before denying a health insurance claim or prior-authorization request based on medical necessity or experimental status. Insurers may not rely solely on AI algorithms, automated decision-support tools, or algorithmic recommendations to deny coverage. The law directly targets automated prior-authorization systems that issue denials without physician involvement. Signed May 12, 2025, effective July 1, 2026. Arizona is among the first states to specifically prohibit AI-only health insurance denials by statute.

Technical detail

AZ HB 2175 (57th Leg., 1st R.S., signed May 12, 2025, eff. July 1, 2026). Amends Arizona insurance law to require: (1) before a health insurer or managed care organization may deny a claim or prior authorization request on the basis of medical necessity, experimental treatment, or similar clinical grounds, a licensed physician or medical director must individually review the specific case; (2) insurers may not use AI-generated recommendations, algorithmic outputs, or automated clinical decision-support tools as the sole basis for a denial. The prohibition applies to prior authorization, utilization review, and claims-level denials. Does not prevent AI tools from assisting review if a licensed physician makes the final determination. Companion to California SB 1120 (Physicians Make Decisions Act, eff. Jan. 1, 2025) and Georgia SB 444 (AI insurance denial ban, 2026).

Who is protected: Arizona health insurance policyholders whose claims or prior authorizations are subject to AI-assisted review

Who must comply: Health insurers, managed care organizations, and utilization review entities operating in Arizona

Key facts

More AI rules in Arizona

• AZ Digital Impersonation Law · In effect
• AZ Election Deepfake Disclosure Law · In effect
• AZ Synthetic Intimate Images Law (SB1462) · In effect
• Arizona Data Center Tax Incentive Moratorium (3-year, 2026) · In effect
• AZ EO 2018-04 (AV oversight) · In effect
• AZ PDD law (HB 2422) · In effect

Related insurance AI rules elsewhere

• NAIC AI Model Bulletin (Insurance) · In effect
• Colorado AI Act (repealed) · Repealed / replaced
• SB 26-189 (Colorado ADMT Law) · Enacted (not yet in effect)
• SB 444 (GA AI Insurance Review) · Enacted (not yet in effect)
• SB 1120 (CA Physicians Make Decisions Act) · In effect
• TX SB 815 (No AI-Only Insurance Denials) · In effect