MedicaidPrior AuthMedium impact
KMAP BULLETIN: Pharmaceutical Prior Authorization Updates
Kansas Medicaid (KanCare)·KS · Oncology, Hematology, Gastroenterology +3 more·Provider Bulletin
Effective date
Jun 16, 2025
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) is requiring Clinical Prior Authorization for 15 specific medications effective June 16, 2025. This includes various specialty drugs like cancer medications, immunosuppressants, and other brand-name pharmaceuticals that may be prescribed by specialists.
Action Required
By June 16, 2025: Providers and billing staff must obtain Clinical Prior Authorization before prescribing or dispensing the 15 listed medications (Focinvez, Rytelo, Ivra, Gomekli, Rezdiffra, Winrevair, Loqtorzi, Raldesy, Otulfi, Selarsdi, Yesintek, Steqeyma, Pyzchiva, Romvimza, Bizengri) for Kansas Medicaid patients. Update EMR systems to flag these medications and create workflow to initiate PA requests. Monitor KanCare MCO implementation dates as they may vary from state effective date.