Admissibility to the United States, eligibility under the employment-based classification the program relies on, successful government vetting, and visa availability. The processing fee and gift are steps in the process, not substitutes for those conditions.
The payment opens a file; it does not decide it
The official program description sets out a sequence: application and nonrefundable processing fee, vetting, and, once instructed, a gift to the United States. Permanent residence is then described as granted through an existing employment-based category as determined by the authorities and subject to visa availability. That means the ordinary immigration questions still apply.
Hypothetical example: a Boischatel physiotherapy clinic owner with a past U.S. visa refusal is told by a consultant that the Gold Card removes such problems; it does not, because admissibility is assessed in the vetting the program describes, and a refusal's underlying reason remains relevant. Health, criminal and prior-overstay grounds are examined as they would be for any immigrant.
The applicant should also confirm which classification the program uses in her case and whether it has its own conditions. The official page is dated and its terms can be revised, so the current version should be reread immediately before any payment.