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MedicaidPrior AuthMedium impact

KMAP BULLETIN: Pharmaceutical Prior Authorization – June 2025 Updates

Kansas Medicaid (KanCare)·KS·Provider Bulletin
Effective date
Jun 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

KMAP (Kansas Medicaid) is changing prior authorization requirements for three medications effective June 1, 2025. Gabarone (gabapentin) will now require prior authorization, Wegovy (semaglutide) will no longer need prior auth, and Gelnique (oxybutynin) and Qdolo (tramadol) are being removed from the preferred drug list entirely.

Action Required

Action needed
Before June 1, 2025: Billing team must update prior authorization requirements in billing system for Kansas Medicaid patients. Remove prior auth requirement for Wegovy (semaglutide), add prior auth requirement for Gabarone (gabapentin), and update status for Gelnique (oxybutynin) and Qdolo (tramadol) as removed from PDL. Notify providers of these changes to ensure proper prescribing workflows. Monitor KanCare MCO implementation dates as they may vary from state policy date.