Five Large Employers Back Electronic Prior Authorization for Self-Funded Plans. Their Statement Sets No Deadline.
Amazon, Axon, Google, Meta and Oracle signed a statement, announced Oct. 21 by CMS and the Labor Department, urging insurers to make electronic prior authorization tools available to self-funded plans. CMS says those plans cover more than 180 million people.
Five large employers, Amazon, Axon Enterprise, Google, Meta and Oracle, have signed a statement urging insurers to make electronic prior authorization tools available to self-funded employer health plans, federal officials announced Oct. 21.
The announcement came from the Centers for Medicare and Medicaid Services (CMS) and the Department of Labor. The statement is voluntary and contains no dates. Until now, the federal push on prior authorization has centered on commitments from health plans and on a CMS rule for the payers it regulates; this is the first step aimed at the employers that sponsor self-funded plans.
What did the five employers sign?
They signed a short Statement of Support for the 2025 Prior Authorization Pledge made by insurers. In it, the employers urge the insurers in the pledge to make the "technical improvements and other capabilities" they are developing "immediately available" to self-insured plan sponsors under the Employee Retirement Income Security Act (ERISA). They also ask carriers and third-party administrators to make other reforms, including changes to which services require prior authorization, available to self-insured plan sponsors "for consideration and adoption." The employers note that self-insured plans often use insurers' platforms to process claims and administer prior authorization, and that the electronic reforms would improve their own plans' processes if those plans are administered on the new platforms.
The statement notes that, as ERISA fiduciaries, plan sponsors must be prudent stewards of plan assets, and it treats reductions in prior authorization as something each sponsor will weigh against its own circumstances. In the background text on the same page, CMS says the employers are calling on their third-party administrators to meet the pledge.
Why do self-funded plans matter to practices?
They are a large share of coverage. CMS said, citing Census data, that more than 53 percent of Americans, more than 180 million people, get coverage through employers that sponsor self-funded plans. Those employers frequently rely on third-party administrators and other service providers to run benefits, including prior authorization, the agency said.
CMS also said a fragmented prior authorization system forces providers to use different workflows depending on a patient's coverage. Its statement page puts it directly: providers "shouldn't need to determine the type of insurance plan a patient is enrolled in" before choosing how to submit a request.
What came before this?
In June 2025, CMS secured voluntary commitments from major health plans to standardize electronic prior authorization, reduce the volume of services subject to it, improve transparency and increase real-time responses, the release says. Separately, the Interoperability and Prior Authorization Final Rule, CMS-0057-F, requires certain impacted payers to implement electronic prior authorization capabilities for medical items and services beginning Jan. 1, 2027. CMS's rule page says impacted payers have until primarily Jan. 1, 2027, to meet its application programming interface requirements.
The statement is a request, not a requirement. What it changes for your office depends on whether insurers and administrators act on it.
"Prior authorization should help patients get the right care, not trap doctors and families in administrative delays," Health and Human Services Secretary Robert F. Kennedy Jr. said in the release. CMS Administrator Dr. Mehmet Oz said patients and doctors "shouldn't have to fall back on faxes and paperwork simply because of how a patient's health plan is funded." Daniel Aronowitz, assistant secretary of Labor for the Employee Benefits Security Administration, which works with employer-sponsored and self-funded plans, said government and private industry are "working together on behalf of the American workforce."
What should practices watch?
Watch whether your largest commercial payers and their administrators announce electronic prior authorization options for self-funded clients, and whether more employers sign on; CMS is taking sign-ons at ePAPledgeEmployers@cms.hhs.gov. Ask your revenue cycle team whether denials and delays can be sorted by plan funding type, so you know how much of your prior authorization work sits in self-funded plans.
For context on the employer side, 70 percent of firms with 200 or more workers told KFF this year that the number of services subject to prior authorization in their largest plan was about the same as last year, as we report in today’s lead story. For the practice-level cost of the process, see The Quiet Math of Prior Authorization.
Reported, fact-checked and edited by The Script Pad's editorial staff.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
