KMAP BULLETIN: 24-Hour Prior Authorization Requirements

Date: 01/20/22

KMAP GENERAL BULLETIN 22004 (PDF)

Effective with dates of service on and after March 1, 2022, for pharmacy drug Prior Authorization (PA) requests requiring additional information, the prior authorization may be pended, and the provider has five business days to submit the requested information. If the supportive information has not been received by the deadline, the initial PA request will be denied due to a lack of information. A new PA request would need to be submitted.

Note: The effective date of the policy is March 1, 2022. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.