HHS and Labor: Five Major Employers Back Expanding Electronic Prior Authorization to Self-Funded Plans Covering 180 Million People
WASHINGTON — The U.S. Department of Health and Human Services (HHS) announced on October 21 that its Centers for Medicare & Medicaid Services (CMS), together with the U.S. Department of Labor (DOL), said five major employers — Amazon, Axon Enterprise, Google, Meta and Oracle — have signed a statement of support for extending the technical improvements and capabilities developed through the 2025 Prior Authorization Pledge to employer-sponsored self-funded health plans.
Prior authorization is the review health plans conduct before covering certain care. HHS said a fragmented system forces providers to navigate different workflows depending on a patient's coverage, with faxes, phone calls and paperwork still common; broader use of electronic prior authorization can reduce manual processes, improve information exchange and cut administrative delays for patients and families.
Citing U.S. Census data, HHS said more than 53 percent of Americans — more than 180 million people — receive coverage through employer-sponsored self-funded plans. Such employers often rely on third-party administrators and other service providers to run health benefits, including prior authorization, and the Labor Department's Employee Benefits Security Administration (EBSA) works directly with the employer-sponsored benefits community, including self-funded plans.
HHS Secretary Robert F. Kennedy Jr. said prior authorization should help patients get the right care rather than trap doctors and families in administrative delays, and that HHS is cutting bureaucracy and modernizing how health plans make coverage decisions. CMS Administrator Dr. Mehmet Oz said patients and doctors should not have to fall back on faxes and paperwork simply because of how a plan is funded. Assistant Secretary for the Employee Benefits Security Administration Daniel Aronowitz said the signing shows government and private industry working together to help employees cut through red tape.
HHS said the employer commitment builds on voluntary commitments CMS secured from major health plans in June 2025 to standardize electronic prior authorization, reduce the volume of services subject to it, improve transparency and increase real-time responses. CMS's Interoperability and Prior Authorization Final Rule also requires certain payers to implement electronic prior authorization capabilities for medical items and services beginning January 1, 2027.
HHS said meaningful reform requires participation across the health system, and that adding employers that sponsor self-funded plans helps build demand for electronic prior authorization across more of the commercial insurance market. Employers interested in supporting the effort can contact CMS at [email protected].
Published by GSM · USA (original Chinese edition)
Photo: 图：位于华盛顿的美国卫生与公众服务部（HHS）总部 Hubert H. Humphrey Building（2026年3月摄）。照片：APK，CC BY 4.0，经 Wikimedia Commons。 / The Hubert H. Humphrey Building, headquarters of the U.S. Department of Health and Human Services in Washington, D.C. (March 2026). Photo: APK, CC BY 4.0, via Wikimedia Commons.
