KEPRO Receives Two Gold MarCom Awards

HARRISBURG, PA – KEPRO announced today that the company has been awarded two MarCom Awards in the 2017 international creative competition that received more than 6,500 entries.  

MarCom Awards honored two of KEPRO’s publications with the Gold Marcom Award in the Print Design-Poster category and the Internal Newsletter category, recognizing KEPRO’s unique and creative take on employee communication and engagement strategies. MarCom is one of the oldest, largest and most-respected creative competitions in the world.

“Being recognized by MarCom for our unique approach to internal communications is a great achievement,” said KEPRO President and CEO Joseph A. Dougher. “Moving forward, we will incorporate our approach externally to further assist our clients in the development of dynamic and creative communication strategies to engage their audiences and encourage healthy lifestyles.”

KEPRO, the nation’s largest CMS-designated quality improvement organization and care management organization, offers innovative and outcomes-focused solutions to reduce the utilization of health care resources and optimize the quality of care for public and commercial clients. Tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients.

To learn more about the services and solutions KEPRO offers, visit

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

About MarCom
MarCom is sponsored and judged by the Association of Marketing and Communication Professionals (AMCP), a 23-year-old international organization consisting of several thousand creative professionals.

Media Contact: Jamie Kopko, Director of Corporate Communications,, 717.564.8288 x7076

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KEPRO to Provide Utilization and Quality Peer Review for New Hampshire Medicaid

HARRISBURG, PA – KEPRO announced today that the New Hampshire Department of Health and Human Services’ Office of Improvement and Integrity has selected KEPRO to provide utilization and quality control peer review services.

The contract includes retrospective reviews for fee-for-service (FFS) paid claims submitted to New Hampshire Medicaid for inpatient services performed at in-state acute care and specialty hospitals.

“We look forward to assisting New Hampshire in analyzing health care delivery and quality,” said KEPRO President and CEO Joseph A. Dougher. “With our experience as the nation’s largest quality improvement organization, we have the knowledge and expertise to ensure program integrity and the delivery of appropriate, quality health care to New Hampshire’s citizens.”

KEPRO will be reviewing patient care to ensure medical necessity, quality of care, appropriateness of decision-making, place of service and length of hospital stay. These services will be provided to approximately 135,000 New Hampshire Medicaid eligible or enrolled recipients.

Additionally, KEPRO will offer an interactive online portal, Atrezzo, which will allow hospital staff to upload the requested documentation to a secure site for review. This enhancement should reduce the administrative burden for hospital staff associated with review functions.

KEPRO provides independent, impartial evaluations of the health care provided on behalf of state and federal governments and is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for more than 30 states.

To learn more about the services and solutions KEPRO offers, visit

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

Media Contact: Jamie Kopko, Director of Corporate Communications,, 717.564.8288 x7076

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KEPRO to Provide Additional Assessment Services for MaineCare

HARRISBURG, PA – KEPRO announced today that the Maine Department of Health and Human Services (DHHS) has awarded KEPRO the Medical Eligibility Determination for the Katie Beckett Benefit and Assessing Services Agency contracts.  

The Katie Beckett Benefit is provided through MaineCare as an option for children with serious health conditions so that they may remain in their homes rather than be institutionalized. KEPRO will conduct medical eligibility determination assessments for children who have applied for MaineCare coverage under the Katie Beckett Benefit.

In addition, KEPRO will now also be Maine’s Assessing Services Agency and will perform eligibility assessments for individuals receiving long term care services and supports and developing Plans of Care. KEPRO will also perform preadmission screening and resident review assessments for individuals with mental illness or intellectual disabilities who apply or reside in a MaineCare certified nursing facility.

“We’re thrilled to expand our services for Maine,” said KEPRO President and CEO Joseph A. Dougher. “For more than a decade we have provided services to assure the delivery of quality and appropriate care to those in need, providing assessments for this benefit is a natural progression in our commitment to the state and their citizens.”

MaineCare is a state and federal-funded program that serves approximately 270,000 citizens. Approximately 1,000 children currently receive the Katie Becket Benefit. KEPRO’s Registered Nurses will conduct roughly 1,500 assessments and re-assessments on an annual basis across the state to determine medical eligibility for the benefit.

Since 2007, KEPRO has served the Maine DHHS in providing a Behavioral Health Utilization Management System for services currently purchased through the State’s Office of MaineCare Services and administered by the Office of Substance Abuse and Mental Health Services, Office of Child and Family Services, and the Office of Aging and Disability Services. In April of this year, KEPRO also began administering MaineCare’s utilization management program.

To learn more about the services and solutions KEPRO offers, visit

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

Media Contact: Jamie Kopko, Director of Corporate Communications,, 717.564.8288 x7076

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Find an Answer

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