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KMAP BULLETIN: High Dollar Rare Disease Drug List Update

Date: 02/15/23

KMAP GENERAL BULLETIN 23024 (PDF)

Effective retroactive to January 1, 2023, additional drugs are now covered on the Managed Care Organization (MCO) High Dollar Rare Disease Drug List.

Drugs added to the High Dollar Rare Disease Drug List effective January 1, 2023:
Drug/BiologicHandling Fee
Amvuttra (vutrisiran)$50
Enjaymo® (sutimlimab-jome)
Hemgenix® (etranacogene dezaparvovec)$250
Onpattro® (patisiran)$50
Ryplazim® (plasminogen- human-tvmh,)
Tegsedi® (inotersen)
Tepezza (teprotumumab)
Ultomiris® (ravulizumab)
Voxzogo® (vosoritide)
Xenpozyme® (olipudase alfa)
Zynteglo® (Betibeglogene autotemcel) *$250

*Only covered if/when the manufacturer participates in the Medicaid Drug Rebate Program.

Note: The effective date of the policy is January 1, 2023. 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.