Reported October 21, 2026: CMS and the Labor Department said five large employers signed a statement supporting electronic prior authorization for employer-sponsored self-funded plans. CMS says more than 180 million Americans receive coverage through employers that sponsor such plans. This is support for expansion—not a mandate or proof that every self-funded plan or third-party administrator can accept electronic requests. A separate CMS rule requires certain impacted payers to offer electronic capabilities beginning January 1, 2027.

DomAfina’s take: identify which referrals involve self-funded coverage and the administrator behind each plan. For every payer, document how requests enter, required clinical fields, where status and denial reasons return, and whether the electronic path has been tested. Keep a controlled fallback until it works. “Electronic” saves time only when the request, response and evidence stay connected to one patient record.

Source reviewed: CMS: Electronic Prior Authorization for Self-Funded Plans. The source supports the reported update; the operational recommendations are DomAfina’s analysis.