The Trump administration revealed Wednesday that five of the country's largest employers will expand electronic prior authorization in self-funded plans.
The Centers for Medicare & Medicaid Services and Department of Labor announced that the companies have signed a statement of support to invest in the technical and other capabilities necessary to advance electronic prior auth, which were outlined in insurers' 2025 pledge on the topic.
The participating employers are Amazon, Google, Meta, Oracle Corporation and Axon Enterprise, per the announcement. CMS and the Labor Department said they have been collaborating to help bring the prior authorization pledge to the self-funded employer market.
"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," said CMS Administrator Mehmet Oz, M.D., in the announcement. "When the entire healthcare system moves together, we can spend less time on paperwork and more time getting patients the care they need."
In June 2025, insurers from across country—including the largest firms as well as smaller payers—agreed to take steps to reform prior authorization, including embracing electronic avenues to prior authorization. A framework for electronic submissions is set to be established and in place by Jan. 1, 2027.
In April, data from major payer industry organizations suggested that insurers had eliminated 11% of prior auths under the reform pledge. Payers had agreed to demonstrate tangible progress toward improvements by the midpoint of 2026.
Self-funded employers generally rely on third-party administrators to manage medical costs as well as services like prior auth. More than half (53%) of Americans are covered by self-funded employer plans, according to Census data, so unlocking improvements there is critical to reach about 180 million people.
Broader adoption of electronic prior authorization can ease administrative burdens for providers, who face a fragmented experience based on a person's individual plan, CMS said. And for patients, it would likely lead to fewer delays and gaps in care thanks to speedier decisions.
The agency urged other employers that might be interested in joining the pledge to reach out.
"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," said Department of Labor Assistant Secretary for the Employee Benefits Security Administration Daniel Aronowitz in the announcement.