MedicaidPrior AuthMedium impact
KMAP BULLETIN: Pharmaceutical Prior Authorization – September 2025 Updates
Kansas Medicaid (KanCare)·KS · Rheumatology, Allergy & Immunology, Dermatology +4 more·Provider Bulletin
Effective date
Oct 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid (KMAP) is implementing new prior authorization requirements for several medications including biologics like Humira, Nucala, and Xolair starting October 1, 2025, with additional medications requiring PA on October 15, 2025. Benralizumab (Fasenra) will no longer require PA after September 30, 2025.
Action Required
By September 30, 2025: Update prior authorization workflows to remove PA requirements for Benralizumab (Fasenra). By October 1, 2025: Implement PA requirements for Adalimumab (Humira), Mepolizumab (Nucala), and Omalizumab (Xolair) in all forms. By October 15, 2025: Add PA requirements for Ustekinumab-ttwe (Pyzchiva), Denosumab products (Xgeva, Jubbonti, Osenvelt, Stoboclo), Ibuprofen 300mg tablets, Metoprolol tartrate oral solution, and Suzetrigine (Journavx). Update billing system PA flags and train staff on new requirements for Kansas Medicaid patients.