Leading Employers Back Expansion of Electronic Prior Authorization to Self-Funded Health Plans

Leading Employers Back Expansion of Electronic Prior Authorization to Self-Funded Health Plans

New employer support increases momentum to modernize prior authorization, reduce administrative burden across employer-sponsored coverage

More patients and doctors could spend less time navigating faxes, phone calls, and paperwork as leading employers work to expand electronic prior authorization for their self-funded health plans. The Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Labor (DOL) today announced that five leading employers have signed a statement of support to make the technical improvements and other capabilities being developed through the 2025 Prior Authorization Pledge available to employers that sponsor self-funded health plans.

"Patients and doctors shouldn't have to fall back on faxes and paperwork simply because of how a patient's health plan is funded," said CMS Administrator Dr. Mehmet Oz. "We've brought insurers, providers, and technology companies to the table to modernize prior authorization, and now employers are helping us take another important step. When the entire healthcare system moves together, we can spend less time on paperwork and more time getting patients the care they need."

"The departments appreciate these U.S. companies for stepping forward to collaborate with Labor and Health and Human Services to help employees cut through red tape and receive their health benefits," said Assistant Secretary for the Employee Benefits Security Administration Daniel Aronowitz. "By signing this statement of support for the expansion of electronic prior authorization reform, government and private industry are working together on behalf of the American workforce."

CMS and DOL are working together to expand the benefits of prior authorization reform to the self-funded market. DOL's Employee Benefits Security Administration (EBSA) works directly with the employer-sponsored benefits community, including self-funded health plans.

Self-funded employers frequently rely on third-party administrators and other service providers to administer health benefits, including prior authorization. According to U.S. Census data , more than 53% of Americans - more than 180 million people - receive their health coverage through employers that sponsor self-funded health plans.

Employers supporting this expansion to the self-funded market include:

• Amazon

• Axon Enterprise, Inc.

• Google

• Meta

• Oracle Corporation

A fragmented prior authorization system forces healthcare providers to navigate different workflows depending on a patient's coverage. Broader adoption of electronic prior authorization can reduce reliance on manual processes, improve information exchange, and make it easier for providers to navigate prior authorization across different types of coverage. For patients and families, more efficient processes could mean fewer administrative delays in accessing care.

The new employer commitment builds on the Trump Administration's work to reduce administrative burden and modernize prior authorization across the healthcare system. In June 2025, CMS secured voluntary commitments from major health plans to standardize electronic prior authorization, reduce the volume of services subject to prior authorization, improve transparency, and increase real-time responses. CMS' Interoperability and Prior Authorization Final Rule also requires certain impacted payers to implement electronic prior authorization capabilities for medical items and services beginning Jan. 1, 2027, while the Health Tech Ecosystem's Electronic Prior Authorization Acceleration initiative brings together providers, health systems, electronic health record developers, health information exchanges, and other organizations to address real-world implementation challenges.

Meaningful prior authorization reform requires participation and accountability across the healthcare system. By adding the voice of employers that sponsor self-funded health plans, CMS and DOL are working to build demand for electronic prior authorization capabilities across additional segments of the commercial insurance market.

Employers interested in supporting the effort or learning more about the Employer Statement of Support can contact CMS at [email protected] .

The Employer Statement of Support for Electronic Prior Authorization can be viewed at https://www.cms.gov/initiatives/electronic-prior-authorization/employer-statement-support .

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