MedicaidPrior AuthMedium impact
KMAP BULLETIN: Pharmaceutical Prior Authorization Updates – October 2025
Kansas Medicaid (KanCare)·KS · Rheumatology, Oncology, Endocrinology +3 more·Provider Bulletin
Effective date
Oct 31, 2025
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) is implementing multiple prior authorization changes for pharmaceuticals with staggered effective dates from October 31, 2025 through December 22, 2025. 19 medications will require new clinical prior authorizations, 3 medications will require new PDL prior authorizations, while 3 medications will have prior authorization requirements removed.
Action Required
By October 31, 2025: Update billing system to reflect prior authorization requirements for affected medications. Remove PDL PA requirements for Abatacept (Orencia®) and Adalimumab-aaty (Yuflyma®). By November 1, 2025: Add PDL PA requirements for Adalimumab-aacf (Idacio) UNBRANDED, Adalimumab-bwwd (Hadlima), and Somatropin (Omnitrope®). By December 21, 2025: Remove clinical PA requirement for Miglustat (Opfolda™). By December 22, 2025: Add clinical PA requirements for 18 new medications including Apremilast, Arimoclomol, and others listed. Monitor KanCare MCO implementation status as dates may vary from stated policy dates.