MedicaidPrior AuthMedium impact
KMAP BULLETIN: Prior Authorization Updates
Kansas Medicaid (KanCare)·KS · Oncology, Hematology, Rheumatology +4 more·Provider Bulletin
Effective date
Mar 17, 2024
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) updated prior authorization requirements effective March 17, 2024, adding 15 specialty medications that now require clinical PA while removing PA requirements for 3 anti-nausea medications. A grandfather PA process protects existing patients with 80% adherence on maintenance drugs.
Action Required
Before March 17, 2024: Billing team must update prior authorization requirements in billing system for 15 new medications including Adzynma, Bimzelx, Pombiliti, Epkinly, Velsipity, Casgevy, Columvi, Lyfgenia, Opfolda, Omvoh, Opdualag, Zynyz, Cosentyx UnoReady/Sensoready pens, Imcivree, and Zepbound. Remove PA requirements for Cinvanti, Emend oral and IV formulations. Update drug authorization protocols and inform providers. Claims for new PA-required medications will be denied without proper authorization.