prior authorization; gold card exemption

SB 1227 creates a "gold card exemption" for healthcare providers in Arizona who consistently meet prior authorization requirements. Specifically, providers submitting at least five prior authorization requests for a specific service in six months with a 90% approval rate qualify for exemption from future approvals for that service. The exemption lasts six months and requires renewal, with insurers allowed to review and rescind it after verifying eligibility through random claim samples. Insurers must provide 30 days' written notice and appeal options if rescinding, directly affecting healthcare providers and insurers managing patient care approvals starting January 1, 2027.