MedicaidCoverageMedium impact
KMAP BULLETIN: Kansas Medicaid Value/Outcomes-Based Agreement – Casgevy®
Kansas Medicaid (KanCare)·KS · Hematology, Oncology, Pediatrics·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Kansas Medicaid will participate in a Value/Outcomes-Based Agreement for Casgevy® (sickle cell gene therapy) starting January 1, 2026. This requires providers to use only authorized treatment centers, participate in a patient registry, cannot bill Casgevy® on inpatient claims, must include NDC codes, and cannot use 340B Program drugs for Kansas Medicaid members.
Action Required
Before January 1, 2026: Providers treating sickle cell disease must verify authorization at CMS-approved centers (currently University of Kansas Medical Center and Children's Mercy Hospital), enroll in CIBMTR patient registry, ensure Casgevy® is billed on outpatient claims only with NDC codes included, and avoid using 340B Program Casgevy® for Kansas Medicaid members. Claims will be denied without registry participation.