MedicaidAdministrativeMedium impact
KMAP BULLETIN: Early Refill Edit for Gabapentin and Pregabalin – Fee-for-Service
Kansas Medicaid (KanCare)·KS · Neurology, Pain Management, Psychiatry +2 more·Provider Bulletin
Effective date
Aug 12, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid (KMAP) changed the early refill edit threshold for Gabapentin and Pregabalin from 80% to 90% of days' supply used before allowing refills. This affects pharmacy dispensing validation and will auto-deny refill attempts when less than 90% of the medication has been used.
Action Required
Effective August 12, 2025: Notify patients taking Gabapentin or Pregabalin that Kansas Medicaid now requires 90% of their medication to be used before refills are approved (increased from 80%). Update patient education materials and inform pharmacy partners of the new early refill validation rules to prevent auto-denials at point of sale.