New Arizona Bill: Insurance Companies Can’t Deny Claims with AI!

Here's the scenario: Something is medically wrong. A visit is made to the family doctor. Your physician orders tests based on your symptoms to determine the cause of the problem so treatment can begin or so you can be referred to a specialist.

Everything seems standard until your doctor's office calls with bad news: your insurance company has denied coverage for your doctor-ordered test, and they won't cover the cost. And the out-of-pocket cost is prohibitive.

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Here's the worst part: there's a good chance your insurance claim was denied without a single human at your insurance company even assessing the situation. Your claim may have been denied by Artificial Intelligence (AI), and now the company is doubling down, and you have no recourse.

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What is Arizona House Bill 2175?

All that is about to change for patients in Arizona. Arizona Governor Katie Hobbs just signed House Bill (HB) 2175 into law.

The new law no longer allows health insurance companies to deny medically necessary claims using AI or an algorithm to determine whether a claim is needed for patient care.

Instead, health insurance companies will be required to have a licensed physician review the case first. That doesn't mean all claims will definitely be covered by your insurance provider; it just means that a qualified, thinking human will make the determination, instead of a computer program.

What Does the New Insurance Law HB2175 Mean for Arizona?

Both the Arizona State Senate and House passed HB 2175 with strong bipartisan support. The bill was introduced due to growing concerns about insurance companies increasing their reliance on AI and algorithm-based tools to automate coverage.

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Sure, the procedure saved the insurance companies money, but patients were not receiving the coverage they needed to manage often complex illnesses. The intention of the bills is to hold insurers accountable, prioritizing their patients' care over profit margins.

The law will take effect in Arizona next July, allowing insurance companies sufficient time to comply with the new regulations.

What are the implications of HB 2175?

House Bill 2175 could turn things around for patients, healthcare providers, and insurance companies in Arizona. Arizona's legislators hope this will lead to a return to prioritizing patient welfare and healthcare transparency over the interests of insurance companies and profits.