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KMAP BULLETIN: Prior Authorization Updates

Kansas Medicaid (KanCare)·KS · Psychiatry, Neurology, Gastroenterology +1 more·Provider Bulletin
Effective date
Dec 18, 2023
We identified it
Jun 21, 2026
Days to comply

Summary

KMAP updated prior authorization requirements for multiple medications effective December 18, 2023. Six medications now require clinical PA including Abilify Asimtufii and Austedo XR, while six others including Amitiza and Increlex no longer need PA. A grandfather process protects compliant patients on maintenance medications.

Action Required

Action needed
Immediately: Update prior authorization workflows for affected medications. Billing team must verify PA requirements before prescribing or dispensing Aripiprazole (Abilify Asimtufii), Deutetrabenazine (Austedo XR), Dextroamphetamine (Xelstrym) Patch, Risperidone (Rykindo/Uzedy) Injections, and Tenapanor (Ibsrela). Remove PA requirements for Lubiprostone (Amitiza), Mecasermin rinfabate (Increlex), Ospemifene (Osphena), Pirfenidone (Esbriet), Somatropin (Zorbtive), Telotristat (Xermelo), and Clobazam (Sympazan). Check patient adherence rates for grandfather PA eligibility on newly restricted maintenance medications.