MedicaidPrior AuthMedium impact
KMAP BULLETIN: Pharmaceutical Prior Authorization Updates – July 2026
Kansas Medicaid (KanCare)·KS · Pharmacy·Provider Bulletin
Effective date
Aug 1, 2026
We identified it
Aug 19, 2026
Summary
Effective August 1, 2026, KMAP (Kansas Medical Assistance Program) is adding 9 medications to the Prior Authorization (PA) requirement list. These include common medications like Loratadine chewable tablets and specialty drugs such as Atomoxetine, Avatrombopag, Denosumab biosimilars, and Rilzabrutinib. Billing teams must implement PA requirements for these medications on or after the effective date, with implementation timing varying by KanCare MCO.
Action Required
Before August 1, 2026: Billing team must update pharmacy billing and prior authorization workflows to require PA for: Atomoxetine (Atoncy™) oral solution, Avatrombopag (Doptelet® tablet and Sprinkle oral granules), Denosumab-bnht (Bomyntra™ and Conexxence™), Denosumab-nxxp (Bildyos™ and Bilprevda™), Loratadine chewable tablets, and Rilzabrutinib (Wayrilz™). Update pharmacy benefit management (PBM) system rules and staff pharmacy staff that these medications now require PDL PA before dispensing. Contact each KanCare MCO to confirm their implementation date, as MCO system status and reprocessing timelines may vary from August 1, 2026. Monitor the KanCare Open Claims Resolution Log for MCO-specific implementation dates. Failure to obtain prior authorization will result in claim denials and delayed patient access to medications.