20-3407. Denial of prior authorization; review of prior authorization
61 words·~1 min read·
/az/title-20/20-3407A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(Eff. 7/1/26)
Before a health care insurer may issue a direct denial of a prior authorization of a service that was requested by a provider and that involves medical necessity, the medical director shall individually review the denial. During each individual review, the medical director shall exercise independent medical judgment and may not rely solely on recommendations from any other source.