Amazon, Google and Other Employers Back Faster Prior Authorizations

On October 21, the U.S. Department of Health and Human Services and Department of Labor announced that Amazon, Axon Enterprise, Google, Meta and Oracle signed a statement supporting the expansion of prior authorization reforms to self-funded employer health plans.

The goal is to reduce the faxes, phone calls and paperwork that can stand between a treatment recommendation and an insurance decision.

What is prior authorization?

Prior authorization is a health plan’s review of whether a requested service or treatment meets its medical necessity requirements. Certain services require approval before care is provided.

For patients, that can mean waiting after a clinician recommends treatment. For medical practices, it can mean collecting records, submitting requests and responding to requests for additional information.

As HealthCare.gov explains, obtaining authorization does not guarantee that the plan will pay the claim. Patients still need to understand their coverage and expected costs.

Why employer participation matters

In a self-funded health plan, the employer takes responsibility for paying covered medical claims. The employer may hire an insurance company or another administrator to handle enrollment, claims processing and provider networks.

That means the employer funding the coverage and the company administering it have different roles. Changes offered by an administrator may also require decisions by the employer sponsoring the plan.

The new CMS employer statement addresses this distinction. Employers are encouraging administrators to make electronic improvements and other prior authorization reforms available to self-funded plans.

The statement recognizes that changes to which services require authorization may be adopted separately by each employer plan. The practical changes will therefore depend on the plan’s decisions and implementation.

What reforms are employers supporting?

The initiative builds on the prior authorization commitments announced by CMS in June 2025.

Participating insurers committed to:

• Standardizing electronic submission of authorization requests.
• Reducing the number of medical services requiring authorization.
• Supporting continuity of care when patients change insurance.
• Explaining decisions and appeal options more clearly.
• Expanding immediate responses to authorization requests.
• Having medical professionals review clinical denials.

These commitments describe the broader reform effort. The October employer statement seeks to extend its capabilities to self-funded plans.

How does this relate to the 2027 deadline?

Separate regulatory and voluntary efforts are underway.

The CMS Interoperability and Prior Authorization Final Rule requires affected payers to implement certain provisions beginning in 2026, with most requirements for electronic data connections beginning in 2027.

Those deadlines apply to the payers and provisions covered by the rule. The employer statement is a separate expression of support, with implementation depending on employers and their administrators.

What could improve for patients and providers?

Consider a patient whose physician recommends physical therapy or diagnostic imaging—services CMS identified when announcing the original reform pledge.

A better electronic process could help the medical office submit the necessary information efficiently and receive a decision with less manual follow-up. Clearer communication could also make it easier to identify missing information or understand a denial.

These are potential benefits. The announcements describe commitments and goals; they do not establish that participating plans have already reduced delays.

For providers evaluating implementation, useful measures include how long decisions take, how often requests must be resubmitted and whether explanations clearly identify the next steps.

Patients waiting for authorization can ask their medical office or plan:

• Has the request been submitted?
• Is additional information needed?
• How can I check its status?
• If it is denied, what review or appeal options are available?

The value of this initiative will be measured in those everyday experiences: whether patients receive timely decisions and whether medical offices spend less time following up on paperwork.