Indiana Selects Kepro For Medicaid FFS Utilization Management Contract

On October 4, 2022, the Indiana Department of Administration selected Keystone Peer Review Organization (Kepro) for a contract for Medicaid fee-for-service (FFS) prior authorization and utilization management (PAUM) services. The contract will run for four years and is valued at nearly $30 million. There may be two one-year renewals. The incumbent to the contract is Gainwell Technologies (formerly DXC Technology) under a contract awarded in 2019.

The PAUM contractor evaluates prior authorization and utilization management cases involving Indiana Medicaid members receiving medical care through the FFS mechanism. Currently, there are more than 327,000 FFS Medicaid beneficiaries . . .