U.S. Labor and Health agencies expand prior authorization reform for self-insured employers

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Prior authorization reform for employers

Highlights

Amazon, Axon, Google, Meta, and Oracle signed a statement supporting the June 2025 Prior Authorization Pledge to expand reforms to self-insured health plans.
The reforms aim to standardize electronic prior authorization, reduce preapproval requirements, ensure clinical review of denials, and call for greater transparency from third-party administrators.
Employer support extends the 2025 Prior Authorization Pledge—which already covers major insurance markets—into the significant self-insured employer segment of the U.S. health benefits system.

Employer support broadens 2025 reform push

As reported by U.S. Department of Labor, the departments of Labor and Health and Human Services say representatives from several large employers with self-insured health plans have signed a statement supporting the expansion of electronic prior authorization reform to self-insured markets.

The statement is signed by delegates from Amazon, Axon Enterprise Inc., Google, Meta and Oracle Corp. It backs the June 2025 Prior Authorization Pledge, which includes six reforms such as standardizing prior authorization submissions, reducing the number of medical procedures requiring preapproval and ensuring clinical denials are reviewed by medical professionals.

Assistant Secretary for Employee Benefits Security Daniel Aronowitz says the companies are working with the two departments to help employees cut through red tape and access health benefits more easily. The statement also calls on third-party administrators to improve transparency and communication around authorization decisions and appeals.

Healthcare administration and workforce impact

CMS Administrator Dr. Mehmet Oz says patients and doctors should not have to rely on faxes and paperwork because of how a health plan is funded. He says insurers, providers and technology companies are already working to modernize prior authorization, and employer participation marks another step in that process.

Over the past year, the Trump Administration and industry partners have implemented electronic prior authorization reforms. In 2025, leading insurance companies signed the Prior Authorization Pledge covering Medicare Advantage, Medicaid Managed Care, Health Insurance Marketplace and commercial plans, and the latest employer support widens that effort into another large segment of the U.S. health benefits system.

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