What Is Gold Carding?
Gold carding, also called expedited credentialing, is a legislative reform that reduces prior authorization requirements for high-performing healthcare providers. Under gold carding laws, providers with excellent clinical outcomes and low denial rates are exempt from routine prior authorization requirements. This streamlines care delivery while maintaining quality oversight.
Gold carding recognizes that high-quality providers have demonstrated clinical judgment and don't need pre-procedure authorization for established, evidence-based treatments. The law typically applies to board-certified specialists with established track records of appropriate care.
Which States Have Gold Carding Laws?
New York was the first state to implement gold carding legislation in 2015. Since then, California, Connecticut, Delaware, Florida, Georgia, Illinois, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, and Washington have passed gold carding laws or similar prior authorization reform measures.
State laws vary in their scope and requirements. Some apply to all procedures, while others limit exemptions to specific procedure categories or high-volume procedures. Requirements for provider qualification also vary by state.
How Gold Carding Affects Patients
In states with gold carding, patients seeing high-performing providers may experience faster care because prior authorization delays are eliminated. However, benefits depend on your provider's eligibility status and your insurer's implementation of the law. Not all insurers have adopted gold carding programs in states where it's legal.
If your provider qualifies for gold carding in your state, ask about it. You may benefit from faster authorization or procedural approval.
The Future of Prior Authorization Reform
Medical organizations including the AMA are pushing for federal prior authorization reform to standardize requirements across states. The AMA has proposed replacing prior authorization with provider credentialing for qualified providers — essentially extending gold carding federally. These efforts continue to gain support among healthcare providers and patient advocates.