MedicaidCoverageMedium impact
KMAP BULLETIN: Preferred Drug List Update – July 2026
Kansas Medicaid (KanCare)·KS · Cardiology, Neurology, Ophthalmology +2 more·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 27, 2026
Summary
Effective July 1, 2026, KMAP is changing the preferred drug list status for four medications (Clonidine 0.05mg, Relgaabi gabapentin 200mg, Tolmetin sodium 200mg, and Zolymbus bimatoprost 0.01%) from Preferred to Non-Preferred, and removing Xolair (omalizumab) from the PDL entirely. Non-Preferred status means PDL policy rules no longer apply to these drugs, requiring billing teams to verify coverage and prior authorization requirements through MCO-specific implementation.
Action Required
By June 30, 2026: Billing team must verify current coverage and prior authorization requirements for the five affected medications (Clonidine 0.05mg, Relgaabi gabapentin 200mg, Tolmetin sodium 200mg, Zolymbus bimatoprost 0.01%, and Xolair omalizumab) through each KanCare MCO partner using NDC and HCPCS lookup tools. Update billing software alerts and prior authorization workflows to reflect new PDL status for each drug. Contact providers in relevant specialties to communicate that these medications are no longer on the preferred list as of July 1, 2026. Note: Implementation dates may vary by MCO—check the KanCare Open Claims Resolution Log for each plan's specific implementation status. Failure to verify coverage may result in claim denials or unexpected patient cost-sharing.