News

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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KEPRO to Provide United Mine Workers of America Health and Retirement Funds with Medical Management Services

Harrisburg, PA, May 6, 2015 - The United Mine Workers of America Health and Retirement Funds (the “Funds”) selects KEPRO, Inc. to provide medical management services. 

Core components of the medical management services include: utilization management functions to ensure services provided to beneficiaries are medically necessary and provided in the most appropriate clinical setting, disease and geriatric case management, and health and wellness services. The overall goal of the Funds’ Medical Management Services Program is to integrate all current programs and provide program enhancements and other innovative strategies to improve the care delivered to beneficiaries while simultaneously lowering the cost of care.

 "We have a long history of designing innovative solutions to meet the health care demands of similar challenging populations and, moreover, delivering measurable results and improvements.  We admire the Funds’ members for their long history of hard work and dedication, and we believe they deserve the very best.  We are excited and eager to begin our work with the Funds’ leadership, its members, and the providers,” said KEPRO President and CEO, Joseph Dougher.

About the Funds

The Funds is a group of multi-employer plans that provides health and retirement benefits to retired coal miners and their eligible dependents. The Funds has been in existence since 1946. At present, the Funds provides pension benefits to over 90,000 beneficiaries and health benefits to nearly 30,000 beneficiaries.

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BFCC QIO Medicare MOA Instructions

In order to participate in the Medicare program, federal law requires certain providers to have a Memorandum of Agreement (MOA) with a Quality Improvement Organization (QIO). MOAs are informational and outline the QIO’s and provider’s responsibilities during the review process.

Medicare providers in the Centers for Medicare & Medicaid Services (CMS) Areas 2, 3 and 4 (District of Columbia, Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia, Alabama, Arkansas, Colorado, Kentucky, Louisiana, Mississippi, Montana, North Dakota, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, Utah, Wyoming, Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio and Wisconsin) need to return a signed MOA to KEPRO by July 31, 2014.

Please download the MOA form and return the signed document to KEPRO by July 31, 2014:

  • Email as an attachment to moa.kepro@hcqis.org, or
  • Fax to 216.654.1547 (Attn: MOA Coordinator)

We also request that you download the Provider Update form and return the completed form with your MOA so that we can update our records and better serve you.

Read more about MOA requirements.

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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