Non-Commercial Research

State Employee Health Plan GLP-1 Prior Authorization Requirements: Kansas SEHP 2026

Educational insurance policy reference. Not medical, legal, or individualized coverage advice.

The Kansas State Employee Health Plan requires CVS Caremark prior authorization for every anti-obesity medication it covers. For weight-management GLP-1 prescriptions or prior authorizations issued or renewed on or after January 1, 2026, the published rule sets a floor of BMI 35 or higher. Wegovy is the preferred GLP-1; Zepbound is non-preferred unless a preferred product was tried and failed or cannot be used for medical reasons.


Kansas also closed the continuation-rule conflict that had appeared in its earlier public records. On May 11, 2026, the Kansas State Employees Health Care Commission adopted a BMI 35 baseline for initial treatment and ongoing therapy and eliminated the separate 5% weight-loss continuation option.


Here is the part the plan's member pages do not assemble in one place: Kansas recorded 8,409 GLP-1 prior authorizations in 2024 — 35.1% of all 23,927 prior authorizations that year — and 7,455 were for weight loss. The older BMI-and-response rules also produced a clean arithmetic breakpoint: a member had to start at BMI 36.85 to lose 5% and still finish at 35. That number explains the conflict Kansas later removed; it is not a current alternative coverage rule.

BMI 35+
Weight-management threshold, initial and ongoing therapy
8,409
GLP-1 prior authorizations in 2024 (35.1% of all PAs)
$11.85M
Reported GLP-1 spending, calendar 2025
May 11, 2026
Date the ongoing-therapy rule was adopted by the Commission

First-screen key facts

Table 1 — Kansas SEHP GLP-1 first-screen key facts
Field Answer
PlanKansas State Employee Health Plan (SEHP)
Prior authorization administratorCVS Caremark
Anti-obesity medicationsPrior authorization required
Weight-management BMI threshold35 or higher
Current treatment-stage ruleBMI 35 applies to initial treatment and ongoing therapy
Original effective dateJanuary 1, 2026
Ongoing-therapy clarification adoptedMay 11, 2026
Preferred GLP-1Wegovy
Non-preferred GLP-1Zepbound; clinical exception route stated by the plan
Grandfathering under the 2025 motionNone; current users were not grandfathered
2024 GLP-1 share of all prior authorizations35.1%: 8,409 of 23,927
2024 weight-loss GLP-1 share of all prior authorizations31.2%: 7,455 of 23,927
Historical BMI needed to lose 5% and remain at 3536.85
Last verifiedJuly 31, 2026

Primary sources: Kansas SEHP GLP-1 page; Plan Year 2026 Active Enrollment Guide; June 3, 2025 HCC minutes; May 11, 2026 HCC booklet; June 17, 2025 HCC meeting booklet. Derived percentages are shown in the methodology below. Retrieved July 31, 2026.

What this is. This is an audit of public plan documents, not a live claims result. Whether an individual request is approved depends on the member's benefit, indication, documentation, formulary status, and Caremark's review. This page is educational and is not medical, legal, or insurance advice.

What are the Kansas State Employee Health Plan GLP-1 prior authorization requirements?

Answer: All anti-obesity medications require prior authorization through CVS Caremark. For GLP-1 treatment used for weight management, Kansas publishes a BMI floor of 35 or higher, requires the prescribed drug to be covered on the SEHP Preferred Drug List, and now applies the BMI floor to both initial treatment and ongoing therapy.

Two current member-facing documents describe the January 1, 2026 rule with slightly different nouns. The SEHP's GLP-1 page applies it to weight-management GLP-1 prescriptions issued or renewed after January 1, 2026. The Plan Year 2026 enrollment guide applies it to prior authorizations issued or renewed on or after January 1, 2026.

The later Commission record supplies the treatment-stage answer that those pages once left muddy. On May 11, 2026, the Commission adopted the BMI 35 baseline for all GLP-1 anti-obesity-medication use and directed that it apply to initial treatment and ongoing therapy.

Table 2 — Kansas SEHP GLP-1 current public-rule matrix

Table 2 — Kansas SEHP GLP-1 current public-rule matrix
Request path Prior authorization BMI or clinical gate Product status Step or exception rule Evidence class
Initial Wegovy for weight management Required, through Caremark BMI 35+ Preferred GLP-1 for weight management No preferred-product prerequisite is publicly stated for the preferred product Current plan rule
Initial Zepbound for weight management Required, through Caremark BMI 35+ Non-preferred Preferred product previously tried and failed, or cannot be used for medical reasons; the prescriber may submit supporting documentation for an exception Current plan rule
Ongoing weight-management GLP-1 therapy Review applies at renewal BMI 35+ applies to ongoing therapy Requested drug must remain covered under the current plan design Drug-specific preference and exception rules still apply Adopted current policy
Former response-based continuation route Historical continuation review At least three months at a stable dose, then at least 5% loss from baseline weight or maintenance of that loss Drug-specific Eliminated as a separate continuation option on May 11, 2026 Superseded official criterion
GLP-1 prescribed for diabetes or another approved condition Condition-specific The public BMI 35 statement is for weight management and does not automatically control another indication Condition- and formulary-specific Caremark maintains criteria by medical condition Current plan scope distinction

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements Dataset, version 2026.07.31. Compiled from the current SEHP GLP-1 page, Plan Year 2026 guide, February 21, 2025 HCC packet, May 11, 2026 HCC booklet, and June 2, 2026 HCC booklet. Retrieved July 31, 2026.

Definitions, because these words are used loosely everywhere else

  • Listed — the drug appears on a formulary or preferred drug list. That alone does not establish approval for a specific member or indication.
  • Preferred — the plan gives the drug preferred formulary treatment. Preferred status does not remove prior authorization or the BMI requirement.
  • Non-preferred — the plan prefers another product first. The current Kansas page states an exception route for Zepbound when the preferred product was tried and failed or cannot be used for medical reasons.
  • Prior authorization — the prescriber submits clinical information for review before the plan covers the requested use.
  • Anti-obesity medication (AOM) — the category Kansas uses for drugs prescribed for weight management, including but not limited to GLP-1-based treatment.
  • Initial treatment and ongoing therapy — the Commission's May 11, 2026 wording for the stages now subject to the BMI baseline.
  • Not publicly verified — the detail was not established in the public documents reviewed. It does not mean the requirement does not exist inside the live claims system.

What changed for ongoing GLP-1 therapy on May 11, 2026?

Answer: Kansas replaced the old public-record conflict with one plan-level rule. The Commission adopted BMI 35 or higher as the baseline for all GLP-1 anti-obesity-medication use, applied it to initial treatment and ongoing therapy, and eliminated the separate 5% weight-loss continuation option.

The timing matters. The January 1, 2026 member-facing rule already said BMI 35 applied when a prescription or prior authorization was issued or renewed. Older Caremark continuation material in the Kansas record separately described approval after at least three months at a stable dose when the member had lost at least 5% of baseline weight or maintained that loss.

Those tests could point in opposite directions. A member could meet the response standard precisely by falling below the BMI floor. Kansas officials discussed that problem in February and April 2026, then the Commission resolved the policy-level conflict in May.

Table 3 — Before and after the May 11, 2026 continuation-policy change

Table 3 — Before and after the May 11, 2026 continuation-policy change
Public-policy stage BMI rule Response rule What the record meant
January 1 – May 10, 2026 BMI 35 stated for prescriptions or prior authorizations issued or renewed Official records also referenced 5% loss from baseline or maintenance after stable-dose therapy Two public criteria existed without a published hierarchy
May 11, 2026 Commission action BMI 35 baseline for all GLP-1 AOM use Separate 5% continuation option eliminated BMI rule expressly applied to initial and ongoing therapy
Current public-policy position as of July 31, 2026 BMI 35 for initial treatment and ongoing therapy No separate 5% pathway in the adopted May rule The policy-level conflict is resolved; live claims mechanics remain plan-administered

Primary sources: February 6, 2026 HCC minutes; April 15, 2026 HCC packet; May 11, 2026 HCC booklet; June 2, 2026 HCC booklet; June 2, 2026 meeting transcript. Retrieved July 31, 2026.

The adopted policy does not publish every claims-system detail. The public record still does not show the exact field Caremark uses for the BMI measurement, the measurement date it accepts, the current authorization duration, or the full submission checklist. Those are operational questions, not a reason to revive the eliminated 5% route.

Why did 36.85 expose the old renewal-rule conflict?

Answer: With height unchanged, a 5% reduction in body weight produces a 5% reduction in BMI. Under the two older public criteria, a member needed a starting BMI of at least 36.8421 — 36.85 rounded upward to two decimals — to lose 5% and still finish at a BMI of 35.

The formula:

minimum starting BMI = required ending BMI ÷ (1 − required weight-loss fraction)
                     = 35 ÷ 0.95
                     = 36.842105…

This remains a useful finding because it measures the conflict Kansas officials were trying to solve. It is not a clinical threshold, it is not a separate eligibility route, and it is not the current continuation rule.

Table 4 — Historical rule interaction: where BMI lands after weight loss

Table 4 — Historical rule interaction: where BMI lands after weight loss
Starting BMI BMI after 5% loss At or above 35? BMI after 10% loss At or above 35?
35.0033.25No31.50No
35.5033.73No31.95No
36.0034.20No32.40No
36.5034.68No32.85No
36.8434.998No under exact arithmetic33.16No
36.8535.01Yes33.17No
37.0035.15Yes33.30No
38.0036.10Yes34.20No
40.0038.00Yes36.00Yes

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements Dataset, version 2026.07.31. Calculated as starting BMI × (1 − weight-loss fraction). Display values are rounded to two decimals except the 36.84 row, where 34.998 is shown to prevent rounding from changing the yes/no result.

Table 5 — Historical minimum starting BMI required to remain at 35

Table 5 — Historical minimum starting BMI required to remain at 35
If the member loses Minimum starting BMI under the old two-rule interaction
5%36.85
10%38.89
15%41.18
20%43.75

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements Dataset, version 2026.07.31. Calculated as 35 ÷ (1 − weight-loss fraction), then rounded upward to two decimal places.

Read the table for what it is: a reproducible explanation of the former conflict. A starting BMI of 40 followed by a 20% loss produces a BMI of 32. That showed why a hard current-BMI floor and a response-based continuation test could not coexist cleanly without a hierarchy. Kansas's May 11 action chose the BMI rule for ongoing therapy and removed the separate 5% continuation option.

When did Kansas adopt and revise the BMI 35 rule?

Answer: The Commission first adopted the BMI 35 restriction on June 3, 2025, with a January 1, 2026 effective date and no grandfathering for current users. After implementation exposed the continuation conflict, the Commission revised the policy on May 11, 2026 by applying BMI 35 to initial and ongoing therapy and eliminating the separate 5% continuation route.

The June 3, 2025 motion passed by unanimous roll call. The minutes recording it were later included in the August 20, 2025 meeting packet, which is why a searcher can easily mistake the publication date for the adoption date.

The no-grandfathering language matters. It shows that the original motion was intended to reach existing users rather than protect them indefinitely under the previous standard. The May 2026 action then made the ongoing-therapy rule explicit.

Table 6 — Kansas SEHP GLP-1 policy and data timeline

Table 6 — Kansas SEHP GLP-1 policy and data timeline
Date Public-record event Why it matters Evidence class
Dec. 10, 2024 HCC materials report $9.2M in net GLP-1 plan spend for January–September 2024 and $1.4M across 3,100 prescriptions in October Establishes the first cost snapshot used in this dataset Official meeting record
Feb. 21, 2025 HCC materials report 3,444 unique anti-obesity GLP-1 utilizers in 2024 and $8.1M in net cost for Wegovy and Zepbound; the 5% continuation criterion appears in the record Establishes the AOM-specific benchmark and historical response rule Official meeting record
June 3, 2025 HCC adopts BMI 35+ for weight-loss GLP-1 coverage beginning Jan. 1, 2026; current users are not grandfathered; motion passes by unanimous roll call Original adoption point Adopted policy
June 17, 2025 HCC materials publish prior-authorization counts, GLP-1 request counts, appeal counts, paid review amounts, and PBM bid pricing; the Commission also addresses the 2026–2028 PBM contract Source of the original PA dataset and fee analysis Official meeting and procurement record
Aug. 20, 2025 Packet publishes the June 3 minutes Publication location of the adoption record Official meeting record
Oct. 1, 2025 Plan Year 2026 guide states BMI 35+ for prior authorizations issued or renewed on or after Jan. 1, 2026 Member-facing operational wording Current plan document
Jan. 1, 2026 BMI 35 rule takes effect Start of the current plan-year threshold Current plan rule
Feb. 6, 2026 HCC discusses the conflict between BMI 35 at renewal and continuation after successful weight loss Public recognition of the rule interaction Policy discussion
Apr. 15, 2026 HCC materials present the option to apply BMI 35 to initial and ongoing therapy and remove the 5% continuation option Proposal that became the May action Policy proposal
May 11, 2026 HCC adopts BMI 35 as the baseline for all GLP-1 AOM use, applies it to initial and ongoing therapy, and eliminates the 5% continuation option Current continuation-policy decision Adopted policy
June 2, 2026 HCC records memorialize the May action; the meeting transcript reports $11.85M in 2025 GLP-1 spending Latest annual spending figure located and confirmation of current policy Official meeting record
July 31, 2026 The RX Index dataset verified Version anchor Dataset release

Primary sources: December 10, 2024 HCC packet; February 21, 2025 HCC packet; June 3, 2025 HCC minutes; June 17, 2025 HCC meeting booklet; August 20, 2025 HCC packet; Plan Year 2026 guide; February 6, 2026 HCC minutes; April 15, 2026 HCC packet; May 11, 2026 HCC booklet; June 2, 2026 HCC booklet; June 2, 2026 transcript. Retrieved July 31, 2026.

Which GLP-1s does Kansas prefer, and what can the public documents establish about member cost?

Answer: Kansas currently identifies Wegovy as the preferred GLP-1 for weight management and Zepbound as non-preferred. The public plan page states that Zepbound may be considered when a preferred product was tried and failed or cannot be used for medical reasons, but the public documents do not establish one universal dollar cost for every member.

The distinction is clinical and formulary-specific:

  • Wegovy: preferred for weight management, with prior authorization and BMI 35 still required.
  • Zepbound: non-preferred under the current Kansas page, with the stated preferred-product exception route.
  • Other products: a drug's appearance on the Preferred Drug List does not, by itself, publish every indication-specific approval criterion.

The public sources do not support mapping Kansas's "preferred" and "non-preferred" labels to one universal 35% versus 60% coinsurance result for Zepbound. Kansas directs members to the Caremark Check Drug Cost tool because the estimated amount depends on the specific medication and selected plan.

CVS Caremark has separately announced that it plans to add Zepbound as an additional preferred option on commercial formularies on October 1, 2026 for plan sponsors that elect the option. That announcement does not change Kansas's current page ahead of Kansas's own adoption or update. As of July 31, 2026, the Kansas page still identifies Wegovy as preferred and Zepbound as non-preferred.

Primary sources: Kansas SEHP GLP-1 page; Q1 2026 Kansas Preferred Drug List; Kansas CVS Caremark benefit page; CVS Caremark formulary announcement. Retrieved July 31, 2026.

Kansas SEHP GLP-1 prior authorization statistics: how many requests were recorded?

Answer: Kansas SEHP recorded 23,927 prior authorizations in 2024. Of those, 8,409 were for GLP-1s and 7,455 were for weight loss, making GLP-1s 35.1% of all prior authorizations and weight-loss GLP-1s 31.2%.

Kansas published the counts in follow-up materials for the June 17, 2025 Health Care Commission meeting. The figures cover the plan's recorded pharmacy prior-authorization and review activity; they do not publish approval and denial outcomes by GLP-1 indication.

Table 7 — Kansas SEHP prior authorizations, appeals, and reviews

Table 7 — Kansas SEHP prior authorizations, appeals, and reviews
Year Prior authorizations Level 1 appeals Level 2 appeals Urgent reviews External reviews
202211,5732162515413
202313,576260161549
202423,9271,1438319925
2025 through May9,87532817697

Primary source: Kansas HCC meeting materials, June 17, 2025. Retrieved July 31, 2026.

What falls out of the table, with the arithmetic kept visible:

  • Prior-authorization volume rose 106.7% from 2022 to 2024. Calculation: (23,927 − 11,573) ÷ 11,573.
  • The 2023-to-2024 increase was 76.2%. Calculation: (23,927 − 13,576) ÷ 13,576.
  • GLP-1s were 35.1% of all 2024 prior authorizations. Calculation: 8,409 ÷ 23,927.
  • Weight-loss GLP-1s were 31.2% of all 2024 prior authorizations. Calculation: 7,455 ÷ 23,927.
  • Weight loss represented 88.7% of the recorded GLP-1 prior authorizations. Calculation: 7,455 ÷ 8,409.
  • Level 1 appeals rose 339.6% from 2023 to 2024. Calculation: (1,143 − 260) ÷ 260.
  • Level 2 appeals rose 418.8% from 2023 to 2024. Calculation: (83 − 16) ÷ 16.

The plan reported paying $815,885 in 2024 for prior authorizations, appeals, and reviews combined. Across the 25,377 recorded events in those five columns, that is a derived blended paid amount of approximately $32.15 per recorded event.

That $32.15 figure is not the contractual price of a standard prior authorization. It blends several review types with different proposed fee schedules and may not capture every accounting adjustment. It is useful as a transparent division of the plan's reported total by its reported event count, and nothing more.

Prior authorization is also a priced administrative service

Caremark's winning 2025 proposal listed $45 per prior-authorization coverage review, with separate prices for appeal categories. In the meeting record, Caremark also said a denied prior authorization and a case closed with no response result in a charge because review work occurred.

Applying the proposed $45 rate to the prior year's counts produces this illustration:

Table 8 — Illustrative application of Caremark's proposed $45 review rate to 2024 volume

Table 8 — Illustrative application of Caremark's proposed $45 review rate to 2024 volume
Measure 2024 count Count × $45
All prior authorizations23,927$1,076,715
GLP-1 prior authorizations8,409$378,405
Weight-loss GLP-1 prior authorizations7,455$335,475

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements Dataset, version 2026.07.31. Counts and proposal pricing come from the June 17, 2025 HCC meeting booklet. This is illustrative arithmetic, not an invoice or a claim about the amount Kansas ultimately paid under the 2026 contract.

The public data do not show how many GLP-1 requests were approved or denied, how many denials resulted specifically from BMI 35, or whether the May 2026 continuation change increased any outcome. That means the fee schedule can be described, but it cannot be turned into a causal claim about the new BMI rule.

Commissioner Vicki Schmidt's recorded dissent stated that Caremark had increased its per-authorization fee by 50% without prior notice to the Commission. Caremark also told the Commission that utilization management saved the plan $26.7 million in 2024. Both statements belong in the record; the public materials reviewed do not provide a full underlying calculation that independently reconciles either figure.

Kansas SEHP GLP-1 spending data: what did the plan report?

Answer: Kansas SEHP reported $9.2 million in net GLP-1 plan spend for January through September 2024 and $11.85 million in total GLP-1 spending for calendar 2025. It separately reported 3,444 unique anti-obesity GLP-1 users in 2024 and $8.1 million in net cost for Wegovy and Zepbound.

These are valid snapshots with different scopes. All-GLP-1 spending includes drugs and indications that are not identical to the Wegovy-and-Zepbound weight-management subset, so the figures should not be chained into one growth rate.

Table 9 — Kansas SEHP GLP-1 cost and utilization snapshot

Table 9 — Kansas SEHP GLP-1 cost and utilization snapshot
Period Measure Value Scope stated in the source
Jan.–Sep. 2024Net plan spend$9.2MAll GLP-1 drugs
Oct. 2024Net plan spend$1.4MAll GLP-1 drugs
Oct. 2024Prescriptions3,100All GLP-1 drugs
Oct. 2024Derived net plan spend per reported prescription$451.61$1.4M ÷ 3,100
Calendar 2024Unique utilizers3,444GLP-1 anti-obesity medications
Calendar 2024Net cost$8.1MWegovy and Zepbound
Calendar 2024Weight-loss GLP-1 prior authorizations7,455Weight-loss indication
Calendar 2025Reported spending$11.85MAll GLP-1 medications

Primary sources: December 10, 2024 HCC packet; February 21, 2025 HCC packet and transcript; June 17, 2025 HCC meeting booklet; June 2, 2026 meeting transcript. Retrieved July 31, 2026.

The cleanest derived spending statistic is this:

Based on Kansas SEHP's reported October 2024 figures, net plan spending averaged approximately $451.61 per reported GLP-1 prescription that month.

That is $1.4 million divided by 3,100 prescriptions. It is not a member copay, a retail price, a monthly cost for one drug, a per-person figure, or a forecast. It is one month's reported net plan spend divided by that month's reported prescription count.

The 7,455 weight-loss GLP-1 prior authorizations and 3,444 unique anti-obesity-medication users come from different records and may not cover identical populations, drugs, or timing. Dividing them would produce roughly 2.2, but that result is not a publishable per-user rate without a matched denominator, so it is not used here.

How does Kansas compare with selected state employee health plans?

Answer: Kansas keeps weight-management GLP-1 coverage but uses a direct BMI 35 gate for initial and ongoing therapy. Other state plans in this verified snapshot use different levers: mandatory prescribing programs, participation requirements, large stand-alone copays, indication limits, or full exclusions.

For adult chronic weight management, FDA labeling for Wegovy and Zepbound starts at BMI 30 or higher, or BMI 27 or higher with at least one weight-related condition. Kansas's BMI 35 plan threshold is therefore more restrictive than the labeled adult initiation threshold. That comparison is about plan eligibility, not medical appropriateness.

Table 10 — Selected state employee health plan GLP-1 decisions, verified July 31, 2026

Table 10 — Selected state employee health plan GLP-1 decisions, verified July 31, 2026
State plan Weight-management GLP-1 position Main access lever Effective or current date
Kansas SEHP Covered under plan criteria BMI 35+ for initial and ongoing therapy; PA; preferred-product rule Jan. 1, 2026; ongoing rule adopted May 11, 2026
Connecticut state plan Covered through designated programs Weight-loss prescriptions covered only through FlyteHealth or Connecticut Children's providers; adult FlyteHealth eligibility is BMI 30+, or 27+ with a related condition; $12.50 monthly program fee Prescribing gate since July 1, 2023; current fee structure in effect
Georgia SHBP Covered for eligible Anthem and UnitedHealthcare members through the designated program 9amHealth is mandatory for new weight-loss prescriptions and for current users when the existing PA expires; Kaiser members are excluded from this program Current 2026 program
Wyoming EGI Covered under expanded program CVS weight-management-program participation plus PA; prior six-month lifetime limit removed Jan. 1, 2026
Delaware GHIP Covered with high stand-alone member cost $200 per 30-day supply for weight-management GLP-1s; excluded from the prescription out-of-pocket maximum July 1, 2026
Colorado state employee plans Covered for members who meet plan criteria Coverage restored after the earlier 2025 restriction May 1, 2026
Massachusetts GIC Not covered for obesity alone; some other approved-condition pathways remain Indication gate July 1, 2026
Indiana state employee plan Not covered for weight loss Benefit exclusion Jan. 1, 2026
North Carolina State Health Plan Not covered for weight loss Benefit exclusion with no grandfathering under the 2024 decision Apr. 1, 2024

Primary sources: Kansas SEHP; Connecticut Care Compass; Georgia SHBP; Wyoming EGI; Delaware weight-loss medication FAQ; Colorado coverage-change FAQ; Massachusetts GIC update; Indiana prescription coverage; North Carolina coverage-exclusion record; FDA Zepbound approval; FDA Wegovy prescribing information. This is a selected comparison, not a fifty-state census. Retrieved July 31, 2026.

Within this selected set, Kansas is notable for putting the restriction directly into the BMI criterion. That does not prove Kansas is the only state plan in the country using a higher BMI threshold; this table is not broad enough to support that claim.

The rebate question the public record does not resolve

North Carolina's State Health Plan published a utilization-management options table showing that several departures from FDA-labeled criteria — including a proposed BMI 40 threshold or BMI 35 with a related condition — were expected to cause a 100% loss of GLP-1 rebates under that plan's arrangement. The same document did not say every possible program had that result: its CVS Weight Loss Program row described an opportunity to earn and keep rebates, with details still to be worked out.

Kansas adopted BMI 35 and later renewed its Caremark relationship, but the Kansas records reviewed for this page do not publish the rebate effect attributable to that threshold. The defensible conclusion is narrow: two public plans working with CVS Caremark published materially different records about how tighter access rules could interact with rebates. The public documents do not establish why.

Primary sources: North Carolina utilization-management options; North Carolina CVS contract fact sheet; Kansas June 17, 2025 HCC meeting booklet. Retrieved July 31, 2026.

How we produced this dataset

Answer: We assembled the current Kansas member-facing rule, the adoption and revision record, the prior-authorization counts, the spending figures, and the selected state-plan comparison into one versioned dataset. Every consequential field is tied to a primary source, an evidence class, a source date, and a verification date; every derived number shows its formula.

Scope

This dataset covers publicly available Kansas SEHP rules and records for GLP-1 and other anti-obesity-medication access, with emphasis on weight-management prior authorization. It uses 2022–2026 records for volume and policy history, and treats July 31, 2026 as the current-policy verification date.

Unit of analysis

Each rule row represents a distinct public-policy path or evidence state: initial preferred-product treatment, initial non-preferred treatment, ongoing therapy, a superseded continuation criterion, or another medical indication. The rows do not represent members, approvals, denials, or clinical outcomes.

Source hierarchy, in order of authority

  1. Current official SEHP member-facing page.
  2. Current plan-year guide and Preferred Drug List.
  3. Adopted Health Care Commission motions and approved minutes.
  4. Official HCC and EAC packets, booklets, and transcripts.
  5. Reproducible calculations derived from published figures.

Evidence classes used throughout

  • Current plan rule — stated in a current member-facing plan document.
  • Adopted policy — stated in a recorded Commission action that passed.
  • Superseded official criterion — documented in an official record but replaced by a later adopted action.
  • Official meeting record — data or operational information presented in an official packet, booklet, minute, or transcript.
  • Policy proposal or discussion — an option or concern raised on the record but not yet adopted at that point in time.
  • Derived calculation — arithmetic performed by The RX Index on published inputs, with the formula shown.

Conflict handling

The later authoritative source controls. A May 2026 adopted action supersedes a February 2025 criterion when the two address the same continuation pathway. A proposal is never coded as adopted. Missing public information is labeled not publicly verified, not silently converted into "not required." A generic Caremark criterion is not substituted for a Kansas-specific adopted rule.

Calculations used on this page

BMI after weight loss       = starting BMI × (1 − weight-loss fraction)
Minimum starting BMI        = required ending BMI ÷ (1 − weight-loss fraction)
Average spend per Rx        = reported net plan spend ÷ reported prescription count
Share of prior auths        = category prior authorizations ÷ total prior authorizations
Change over time            = (later count − earlier count) ÷ earlier count
Blended paid amount/event   = reported paid amount ÷ total recorded review events
Illustrative PA fee amount  = recorded PA count × proposed per-review fee

Table 11 — Core Kansas source ledger

Table 11 — Core Kansas source ledger
Source Source date What it supports Evidence treatment
SEHP GLP-1 page Current as verified July 31, 2026 PA requirement, BMI 35, PDL requirement, Wegovy preference, Zepbound exception, condition-specific criteria Current rule
Plan Year 2026 Active Enrollment Guide Plan year 2026 PA issued-or-renewed wording and Jan. 1, 2026 date Current plan document
Q1 2026 Preferred Drug List Jan. 1, 2026 Current-quarter formulary context Current plan document
June 3, 2025 HCC minutes June 3, 2025 Original BMI 35 adoption, Jan. 1 effective date, no grandfathering, vote Adopted policy
June 17, 2025 HCC booklet June 17, 2025 PA, appeal and review counts; GLP-1 counts; paid amount; proposal fees; PBM record Official meeting/procurement record
February 21, 2025 HCC packet Feb. 21, 2025 2024 AOM utilization/cost and former continuation criterion Official historical record
December 10, 2024 HCC packet Dec. 10, 2024 2024 GLP-1 net-spend and prescription snapshot Official meeting record
February 6, 2026 HCC minutes Feb. 6, 2026 Public discussion of ongoing-therapy conflict Policy discussion
April 15, 2026 HCC packet Apr. 15, 2026 Proposed resolution of BMI/5% conflict Policy proposal
May 11, 2026 HCC booklet May 11, 2026 BMI 35 for all GLP-1 AOM use, initial and ongoing therapy, elimination of 5% option Adopted current policy
June 2, 2026 HCC booklet and transcript June 2, 2026 May-action record and 2025 spending statement Official meeting record

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements Dataset, version 2026.07.31. Retrieved July 31, 2026.

Verification and versioning

The current-rule fields were checked against the SEHP's current GLP-1 page and Plan Year 2026 materials on July 31, 2026. Historical records are kept under their original dates and are not allowed to override the later May 11, 2026 action. A material change to the BMI rule, preferred product, exception route, PDL, or ongoing-therapy policy requires a new verification date and dataset version.

What this dataset does not show

Answer: This is a record of public policy and reported plan data, not the live Caremark claims system. It cannot tell a member whether a particular request will be approved, what a particular prescription will cost, why a particular claim was denied, or which exact fields a prescriber will see during submission.

The public sources reviewed do not establish:

  • The exact date or encounter from which Caremark takes the BMI used for an ongoing-therapy review.
  • The full current submission-document checklist, including every field, diagnosis code, laboratory item, or attachment.
  • The current authorization duration for each product and indication.
  • Approval and denial counts for GLP-1 requests.
  • How many denials were caused by BMI 35.
  • A universal member price for Wegovy or Zepbound.
  • Drug-specific criteria for every product appearing on the PDL.
  • The criteria for diabetes, cardiovascular-risk reduction, obstructive sleep apnea, MASH, or another condition beyond the plan's statement that Caremark maintains condition-specific criteria.
  • The rebate consequence Kansas accepted, avoided, or negotiated when it adopted BMI 35.

The May 11 action resolves the public policy hierarchy between BMI 35 and the former 5% route. It does not expose every operational field Caremark uses to implement that policy.

Limitations

Answer: The strongest current rules are clear, but the operational record remains fragmented across member pages, guides, Commission minutes, packets, and transcripts. The dataset keeps those evidence classes separate so an old criterion, a proposal, and a current rule do not get blended into one answer.

  • Public documents can lag decisions. The June 3, 2025 motion appeared in a later packet, and the May 11, 2026 action is not fully reproduced on the current member-facing GLP-1 page.
  • The May action is a policy rule, not a claims screenshot. It establishes BMI 35 for ongoing therapy but does not publish all adjudication mechanics.
  • Cost figures cover different scopes and periods. All-GLP-1 spend, AOM utilization, and Wegovy-plus-Zepbound net cost are different measures.
  • The $45 fee table is illustrative. It applies proposed contract pricing to prior-year counts; it is not a billed amount.
  • The $32.15 figure is blended. It divides a combined paid amount by several types of recorded review events.
  • The state comparison is selected, not exhaustive. It cannot support a claim that Kansas is nationally unique.
  • Formulary status can change. CVS has announced an October 1, 2026 commercial-formulary option involving Zepbound, but Kansas must be checked again before its current status is changed here.
  • "Not publicly verified" does not mean "not required." It means the field was not established in the public evidence used for this version.
  • This page is educational. For a decision about treatment or coverage, speak with a licensed prescriber and request the current criteria and member-specific cost from Caremark or the SEHP.

How to cite this page

Answer: Use the dataset version and verification date so the cited finding can be traced to the exact Kansas policy snapshot. The format below is neutral attribution information, not a request for a citation.

Full citation

The RX Index Editorial Team. "State Employee Health Plan GLP-1 Prior
Authorization Requirements: Kansas SEHP 2026." The RX Index Research.
Dataset version 2026.07.31. Last verified July 31, 2026.
https://therxindex.com/research/state-employee-health-plan-glp-1-prior-authorization-requirements/
Accessed [Month Day, Year].

For a copied table

Source: The RX Index Kansas SEHP GLP-1 Public-Record Requirements
Dataset, version 2026.07.31.

Frequently asked questions

Does Kansas SEHP require prior authorization for Wegovy?

Yes. Kansas SEHP states that all anti-obesity medications require prior authorization through CVS Caremark. Wegovy is the current preferred GLP-1 for weight management, but preferred status does not remove the BMI 35 requirement or the review.

What BMI does Kansas SEHP require for a weight-management GLP-1?

BMI 35 or higher. The plan's current page and Plan Year 2026 guide apply the threshold to prescriptions or prior authorizations issued or renewed on or after January 1, 2026, and the May 11, 2026 Commission action applies it to initial and ongoing therapy.

What changed on May 11, 2026?

The Commission adopted BMI 35 as the baseline for all GLP-1 anti-obesity-medication use, applied it to initial treatment and ongoing therapy, and eliminated the separate 5% weight-loss continuation option. That superseded the older public-record conflict described earlier on this page.

Is Zepbound covered by Kansas SEHP?

Zepbound is currently non-preferred under the Kansas plan page. The page states that the member must have tried and failed a preferred product or be unable to use it for medical reasons, after which the prescriber may submit documentation to Caremark for an exception review.

Does the BMI 35 rule apply to Ozempic or Mounjaro prescribed for diabetes?

Not automatically. Kansas publishes BMI 35 as a weight-management criterion and states that Caremark has separate prior-authorization criteria for each approved medical condition. A diabetes request must be evaluated under the applicable condition-specific and formulary rules.

What happens if treatment lowers a member's BMI below 35?

The current public policy applies BMI 35 to ongoing therapy. The public documents do not show the exact measurement timing, form field, or claims-system workflow Caremark uses, so a member facing renewal should request the current criteria in writing. The 36.85 calculation on this page describes the former rule conflict; it is not a current exception.

Were existing users grandfathered when Kansas adopted BMI 35?

No. The June 3, 2025 motion states that current members using GLP-1s would not be grandfathered when the BMI 35 restriction took effect.

When was the Kansas BMI 35 rule adopted, effective, and revised?

It was adopted June 3, 2025, took effect January 1, 2026, and was revised on May 11, 2026 to apply BMI 35 to initial and ongoing therapy while eliminating the separate 5% continuation option.

How many Kansas SEHP prior authorizations were for GLP-1s?

In 2024, 8,409 of the plan's 23,927 prior authorizations were for GLP-1s, and 7,455 were for weight loss. Those equal 35.1% and 31.2% of all prior authorizations, respectively.

How much did Kansas SEHP report spending on GLP-1 medications?

The plan reported $9.2 million in net GLP-1 plan spend for January through September 2024 and $11.85 million in all-GLP-1 spending for calendar 2025. It separately reported $8.1 million in 2024 net cost for Wegovy and Zepbound across 3,444 unique anti-obesity-medication users.

Changelog

2026-07-31 — v2026.07.31 — Initial publication. Current policy incorporates the May 11, 2026 HCC action applying BMI 35 to initial and ongoing therapy and eliminating the former 5% continuation option. Source ledger covers 11 primary documents spanning December 2024 through July 2026.