MedicaidPrior AuthHigh impact
KMAP BULLETIN: Preferred Drug List Update
Kansas Medicaid (KanCare)·KS · Oncology, Hematology, Neurology +2 more·Pharmacy
Effective date
Jun 17, 2024
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) is implementing prior authorization requirements for 17 specialty medications effective June 17, 2024, while removing prior auth requirements for 3 medications. This affects high-cost specialty drugs primarily used in oncology, neurology, and endocrinology.
Action Required
Before June 17, 2024: Billing team must update prior authorization processes for 17 specialty medications including Vegzelma, Truqap, Vyvgart, Elrexfio, Ojjaara, Aphexda, Akeega, Kepivance, Udenyca OnBody, Vanflyta, Augtyro, Rystiggo, Lumryz, Sogroya, Ngenla, Talvey, and Zilbrysq. Remove prior auth requirements for Blenrep (effective June 17) and Revatio oral suspension/tablets (effective June 1). Update billing system flags and notify providers that claims for affected medications will be denied without proper prior authorization.