Under the law, physicians who have a 90 percent prior authorization approval rate over a six-month period on certain services are exempt from prior authorization requirements for those services.
Their exemption is referred to as their “gold card.” Since physicians with gold card status consistently meet prior authorization requirements for certain services, state-regulated insurers won’t delay care for those services.
Gold carding is a prior authorization reform supported by numerous medical associations, including the American Medical Association, American Hospital Association, American Pharmacists Association and American Academy of Family Physicians.
