THE BUSINESS OF MEDICINETransparency in Prior Authorization The Under-recognized Precedent Set by ArkansasKebaish, Kareem J. BA; Galivanche, Anoop R. BS; Grauer, Jonathan N. MDAuthor Information Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT J.N.G. reports personal fees from TIDI Products (Past but within 3 y) and personal fees from North American Spine Society, outside the submitted work. He is a Fellow of the American College of Surgeons. The remaining authors declare no conflict of interest. Reprints: Jonathan N. Grauer, MD, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, 47 College Street, New Haven, CT 06511 (e-mail: email@example.com). Clinical Spine Surgery: October 2020 - Volume 33 - Issue 8 - p 325-327 doi: 10.1097/BSD.0000000000001032 Buy Metrics Abstract Prior Authorization (PA) is an insurance policy that requires providers to obtain permission before delivery of certain medical services. The aim is to ensure appropriate utilization of health care on the basis of clinical guidelines and to minimize costly procedures. The overall impact of PAs has not been well studied; however, many arguments exist in support and opposition to this practice. The Prior Authorization Transparency Act and the Healthcare Transparency Initiative are legislations enacted by the state of Arkansas to study and mitigate the effects of PAs. These legislations are particularly relevant to orthopedic surgery, as many orthopedic procedures and services require PA. There is limited evidence regarding the effects of PAs on the field of orthopedics. Studying these effects is critical to ensuring high-quality care for patients and reducing administrative and provider burden associated with PAs. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.