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KEPRO Achieves URAC Disease Management Accreditation

January 25, 2012, Harrisburg, PA

KEPRO Acquisitions, Inc, (KEPRO) a fully owned subsidiary of the Keystone Peer Review Organization, Inc., was recently awarded URAC Accreditation for its disease management program. The company also has URAC health utilization management and case management accreditation.

“KEPRO has delivered high quality care management services to public and commercial clients for over 26 years,” said Joseph A. Dougher, president and chief executive officer. “URAC accreditation demonstrates our commitment to delivering health utilization management, case management, and disease management programs that meet or exceed industry standards, improve overall participant health, and reduce client health care costs.”

“By applying for and receiving URAC Disease Management Accreditation, KEPRO has demonstrated a commitment to quality health care,” said Alan P. Spielman, URAC president and CEO. “Quality health care is crucial to our nation’s welfare and it is important to have organizations that are willing to measure themselves against national standards and undergo rigorous evaluation by an independent accrediting body.”

URAC’s accreditation standards address approaches to ensuring appropriate patient protections have been established, such as policies for confidentiality of patient information, informed consent, dispute resolution and other issues. The standards cover staff structure and qualifications, quality improvement, information management, oversight of delegated functions, ethics, complaints, and the health utilization, case and disease management processes.

About URAC
URAC, an independent, nonprofit organization, is a leader in promoting health care quality through
accreditation and certification programs. URAC's standards keep pace with the rapid changes in the
health care system, and provide a mark of distinction for health care organizations to demonstrate their
commitment to quality and accountability. For more information, visit www.urac.org.

About KEPRO

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. KEPRO’s comprehensive, member-centric care management solutions go far beyond traditional utilization and case management by coordinating the care provided to members with acute, chronic and complex conditions across the continuum, and identifying members who are at the highest risk for future services, but have not yet had an acute event. Tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients.

Headquartered in Pennsylvania, KEPRO also has offices in Alabama, Florida, Illinois, Maine, Maryland, Massachusetts, Minnesota, Ohio, Oregon, South Carolina, Tennessee, Virginia, and West Virginia. KEPRO is URAC accredited in case management and health utilization management. We are also National Institute of Standards and Technology (NIST) and Federal Information Security Management Act (FISMA) certified.

 

 

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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