News

KEPRO Awarded New Contract in Minnesota for Emergency Medical Assistance

HARRISBURG, PA – KEPRO announced today it was recently awarded a new contract with the state of Minnesota to manage the Emergency Medical Assistance Program on behalf of the Minnesota Department of Human Services.

“We’re excited to expand our services for the state of Minnesota,” said Joe Dougher, President and Chief Executive Officer. “Over the past 3 years we have worked to provide utilization management for the state’s Medicaid program and this opportunity allows us to further enhance our healthcare services for Minnesotans.”

KEPRO currently manages Minnesota’s Fee-for-Service Medicaid program and helps 315,000 members receive the quality care they need through utilization management. KEPRO’s clinical team, based in Bloomington, determines the medical necessity of various healthcare procedures, treatments, and health services, including mental health services for both children and adults, dental services, and durable medical equipment.

With the new contract, KEPRO will provide services to support the management of the Emergency Medical Assistance (EMA) program. EMA covers the care and treatment of non-citizens who would otherwise qualify for Medicaid for emergency medical conditions provided in the Emergency Department or inpatient hospital. EMA also covers some care and treatment provided in other settings without which a patient’s health would be in serious jeopardy, including dialysis and cancer treatments. KEPRO will review submitted Care Plan Certification requests to determine if individuals meet established criteria for coverage.

KEPRO, a leading quality improvement and care management organization, offers innovative and outcomes-focused solutions to reduce the utilization of health care resources and optimize quality of care for public and commercial clients. KEPRO’s tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients alike. To learn more about KEPRO, visit www.KEPRO.com.

 

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KEPRO Announces Two New Executive Appointments

HARRISBURG, PA – KEPRO is pleased to announce the appointments of Meghan Harris as Executive Vice President and Michael Wolf as Vice President for Government Relations.

In addition to being the Chief Operating Officer, Harris has also been appointed as the Executive Vice President and now heads Operations, IT, Health Service Research and Quality for KEPRO. Harris is also responsible for KEPRO’s public and commercial operations, providing operational leadership to achieve company-wide goals and objectives. Harris brings nearly 17 years of experience in the health services research field, with expertise in biostatistics, experimental design, sampling, regression, health outcomes, and savings calculations.

“Meghan has been a keystone in the fabric of KEPRO and the work that we do,” said KEPRO President and CEO Joseph A.  Dougher. “We’re very excited to have her as our Executive Vice President and operational leader in achieving our goals and objectives.”

Harris earned her Bachelor of Science degree in mathematics from Malone College in Canton, Ohio; and her Master of Science degree in Statistics from the University of Akron. She is a member of the Cleveland Chapter of American Statistical Association, the American Society for Quality, and the American Health Quality Association.

In addition, KEPRO is pleased to announce that Wolf will lead public affairs and policy efforts on a national level on a variety of health care initiatives including access to care and integration of care issues in public healthcare payer programs.

“Michael‘s expertise and experience in state government will be invaluable as we grow and increase our government and commercial clients,” Dougher stated. “He will be the lead on coordinating with government entities to develop effective and cost-efficient programs for their members.”

With more than 10 years of experience in the health industry and most recently serving as the Secretary of the Pennsylvania Department of Health, Wolf will play a crucial role in developing new government partnerships and identifying innovative ways KEPRO can better serve our clients and their members through cost-saving measures.

Wolf is recognized as the leader of Pennsylvania’s State Innovation Model efforts with the Center for Medicare and Medicaid Innovation Center spearheading efforts to create greater adoption of patient-centered medical homes and greater use of technology to help address medically-underserved. Wolf will also oversee KEPRO’s Communications Office to better align KEPRO’s brand and to enhance two-way communication with clients and members.

KEPRO, a leading quality improvement and care management organization, offers innovative and outcomes-focused solutions to reduce the utilization of health care resources and optimize quality of care for public and commercial clients. KEPRO’s tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients alike. To learn more about KEPRO, visit www.KEPRO.com.

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KEPRO in Partnership with Consonance Capital Partners Completes the Acquisition of APS Healthcare from Universal American

Combination Creates Premier Quality Improvement and Care Management Organization

HARRISBURG, PA - KEPRO, Inc. (“KEPRO”), a leading quality improvement and care management organization, in partnership with Consonance Capital Partners ("Consonance"), a leading healthcare private equity fund, announced that they have acquired APS Healthcare from Universal American.

The combination will enhance KEPRO’s ability to provide a comprehensive and high quality set of service offerings through an integrated approach to medical management – an area that will continue to experience strong growth as a result of shifting reimbursement models and changing regulatory requirements. The company’s wide breadth of services will continue to include member centric care management solutions, physical and behavioral health utilization management, employee assistance and absence management programs, as well as other offerings such as pre-admission screening and resident reviews.

Joseph Dougher, President and Chief Executive Officer of KEPRO, said, “APS Healthcare has built a reputation as a leader in medical management and together, KEPRO and APS Healthcare are dedicated to providing additional value through differentiated programs that truly meet our customers’ specific needs. The culture and values of both companies are well aligned, and APS Healthcare will bring a wealth of expertise to the combined company. We are excited to partner with APS Healthcare to continue to provide outcomes-focused solutions to reduce unnecessary healthcare utilization and optimize care quality for all of our customers.”

Stephen McKenna, Managing Partner of Consonance Capital Partners, said, “APS Healthcare has a long history of providing customers with high quality services that help improve outcomes while lowering costs, and I am confident that the complementary industry-leading expertise KEPRO brings will enable the combined company to continue to grow and further solidify its longstanding commitment to its customers.”

Consonance Capital Partners was advised by Latham & Watkins, LLP and Foley & Lardner LLP.

About Consonance Capital

Consonance Capital Partners invests in private companies in the lower middle market of the U.S. healthcare industry with an emphasis on businesses driving efficiency, cost containment and high quality clinical care to patients. Consonance Capital Partners founders, Mitchell Blutt, MD, Benjamin Edmands, Stephen McKenna, and Nancy-Ann DeParle, partnered together for over a decade while at JPMorgan Partners and its successor and predecessor entities, and have over 70 years of combined experience in private equity investing, primarily within healthcare. Consonance Capital Partners participates in growth equity, leveraged buyout, and recapitalization transactions and is currently investing out of a $500 million fund. The private equity fund is associated with Consonance Capital Management, a healthcare-focused long/short public equity manager, and together Consonance Capital has over a billion dollars of assets under management. For more information, visit www.consonancecapital.com.

About APS Healthcare

APS Healthcare, headquartered in Mechanicsburg, PA, is a leading provider of specialty healthcare solutions. APS delivers customized, integrated healthcare solutions that help people engage in behaviors that optimize their health status. By uniting all participants in the healthcare landscape – individuals, practitioners and payers – APS Healthcare improves overall health and reduces total healthcare expenditures.

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Please describe KEPRO data security that ensures member information is protected.

As an organization that is charged with storing and transferring Protected Health Information (PHI), KEPRO is bound by HIPAA regulations, and is accustomed to managing the security and privacy of PHI. KEPRO currently exchanges data successfully and confidentially via secure encrypted means in support of all of our federal, state, and local government programs, and with commercial clients.

KEPRO has been implementing and supporting systems that require medical record, data security, and transmission for more than a quarter of a century, and has always placed primary importance on using systems that allow for fast and efficient connectivity, while still providing the highest level of data and system security. Our proven internal and external policies and protocols ensure compliance with state and federal laws and regulations, as well as any additional security measures you may require.

We have a stringent KEPRO Comprehensive Confidentiality Plan that governs our processes. KEPRO’s Privacy Officer, Security Officer, and the Compliance Officer have ultimate responsibility for oversight of the processes and procedures contained in the KEPRO Comprehensive Confidentiality Plan.

KEPRO's system is secure. Our information systems are secured by an in-depth strategy that utilizes multiple layers of operational, management, and technical controls to protect KEPRO assets. We also employ software programs designed to prevent unauthorized use by staff or outside entities.

All KEPRO information systems employ common security controls such as Firewalls, Anti-virus, Role Based Access, FIPS 140-2 Encryption for mobile devices, and the requirement of strong passwords. Information system users are assigned a security role based upon access requirements relevant to their positions and information/program privileges.

The HIPAA Security Rule requires entities to implement information systems that control access to healthcare and related systems. KEPRO adopts a subset of NIST 800-53 Rev 3 Security controls to maintain compliance with HIPAA. Based on these security standards, KEPRO mitigates risk to its Information system by focusing on such controls as:

  • Log-In Security. HIPAA security requires the use of secure User IDs and the use of passwords. KEPRO requires multiple account authentication processes within its information systems to verify the identities of our end-users. KEPRO's policy requires strong passwords that are changed frequently.
  • Access Control. HIPAA requires one of the following: Context Based Access, Role Based Access, or User Based Access. User Based Access is part of the Log-In Security component. KEPRO's Role Based Access gives individual users access relevant to their function in the organization.
  • Audit Trail. HIPAA requires the use of an audit trail to identify who accesses PHI. KEPRO systems track those who change the patient record, the date and time the record was modified, and the specific information changed. The system includes a read only audit trail that captures each time a system user views a case.
  • Session Time-out. KEPRO information systems account for session inactivity by locking screens after 10 minutes of inactivity.
  • KEPRO's physical space is secure. KEPRO’s computer, telephone, and hardware systems are located in climate controlled rooms with fire-suppression and electronic locking system. We allow only authorized access to the room.
  • KEPRO focuses training on confidentiality and security issues. All KEPRO employees undergo rigorous training on security and confidentiality of PHI. We have successfully provided this training to all staff regardless of their respective roles/duties.

KEPRO Headquarters

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777 East Park Drive, Harrisburg, PA 17111
Toll-free: 800.222.0771
Phone: 717.564.8288
Fax: 717.564.3862