News

Paul Solomon Named KEPRO Chief Financial Officer

HARRISBURG, PA – KEPRO announced today that Paul Solomon has been named Chief Financial Officer (CFO) of KEPRO.

Mr. Solomon brings more than 30 years’ experience to KEPRO, including an extensive background in financial and operational leadership, including corporate finance and accounting, financial planning and analysis, investor relations, strategic planning and business development.

Mr. Solomon will be responsible for the direction and leadership of KEPRO’s financial functions and performance to facilitate KEPRO’s growth, create equity value and further position the organization to build lasting partnerships to enhance KEPRO’s portfolio of services for public and commercial clients.

“Paul’s financial acumen and broad experience achieving growth, improved service and operational efficiencies will be instrumental in KEPRO’s future growth,” said KEPRO President and CEO Joseph A. Dougher. “We are thrilled to have Paul on our team and for his leadership in KEPRO’s financial and operational performance.”

Mr. Solomon has significant prior experience working with a wide array of health services companies.  Most recently, Mr. Solomon was the Chief Financial Officer for VetCor Professional Practices, LLC, where he managed all financial activities for the $350 million revenue company, including accounting, tax, financial planning and audit, budget, payroll, accounts payable and cash management. During his time as CFO of VetCor and other health care companies, Mr. Solomon played an integral role in business development, capital raising and recapitalizations, financial and operational improvements, program redesigns and contract negotiations, resulting in significant cost savings and revenue generation.

“Mr. Solomon’s expertise in the implementation of strategic growth plans focused on organic and acquisitive growth, cost efficiencies and process improvements will be an asset to KEPRO,” said Dougher.

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

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, JKopko@Kepro.com, 717.564.8288 x7076

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KEPRO to Provide Additional Call Center Services to TennCare

HARRISBURG, PA – KEPRO announced today that the Division of TennCare, the state of Tennessee’s Medicaid program, has awarded the contract for the management of its toll-free call center to support TennCare members to KEPRO.

KEPRO will manage the toll-free call center that allows TennCare’s members to file medical issues or appeals by phone. The call center currently receives an average of 2,500 calls per week.

“For the past decade, KEPRO has had the honor of supporting TennCare and its members through appeals management,” said KEPRO President and CEO Joseph A. Dougher. “We look forward to not only continuing our partnership, but expanding our services to ensure all TennCare members receive the right care at the right time.”

Since 2007, KEPRO has supported the TennCare program through medical necessity, clinical contraindication and hardship reviews, providing medical testimony at fair hearings, in addition to various quality improvement initiatives through audits and analytical analysis. KEPRO also provides training on medical and eligibility appeals processing, as well as onsite IT support. 

KEPRO’s management of the toll-free call center will include requests for medical (including physical health and behavioral health) or pharmacy services, reimbursement, billing relief, and health plan changes, as well as requests for reconsideration of adverse actions, including denials, delays, reductions, suspensions, and termination of coverage.

KEPRO will begin managing the call center on September 1. 

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

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, JKopko@Kepro.com, 717.564.8288 x7076

About TennCare

TennCare is the state of Tennessee’s Medicaid program which provides health insurance to approximately 1.5 million low-income Tennesseans including pregnant women, children, caretaker relatives of dependent children and older adults and adults with physical disabilities. With a satisfaction rating above 90 percent since 2009 TennCare provides health insurance through the use of managed care.    

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KEPRO to Implement Minnesota’s Retrospective Review Program for State Medicaid

HARRISBURG, PA – KEPRO announced today that it was awarded a new contract with the state of Minnesota Department of Human Services to perform all retrospective, post-payment reviews for the state’s fee-for-service Medicaid program.

KEPRO will be developing and implementing the state’s first program to conduct retrospective and post-payment reviews to identify outpatient and inpatient initiatives to enhance the delivery of services and improve overall health outcomes for members of the state’s Medicaid program.

“We’re grateful for this opportunity to continue our work in the state of Minnesota,” said KEPRO President and CEO Joseph A. Dougher. “This program allows us to identify areas where we can deliver outcome-focused solutions to maximize services and improve the quality of life 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 also supports the management of the Emergency Medical Assistance (EMA) program that 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. In addition, KEPRO performs reviews for level of service requests for non-emergency transportation for Fee-for-Service recipients to and from appropriate health care providers and facilities.  

KEPRO’s reviews will identify outliers that indicate policy gaps, training needs, and trends in order to encourage best practices in medical care, record keeping, and billing. KEPRO will also be reviewing provider claims to ensure that documentation adheres to the Minnesota Health Care Programs Provider manual, nationally recognized clinical criteria and best practices for medical claims coding.

“We’ll be assisting Minnesota in ensuring efficiency and program integrity in the delivery of Medicaid services for their citizens,” stated Dougher.

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

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, JKopko@Kepro.com, 717.564.8288 x7076

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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