Virginia Medicaid Awards Kepro Contract For FFS Medical & Behavioral Authorizations, Magellan’s BHSA Contract To End

On April 10, 2023, the Virginia Department of Medical Assistance Services (DMAS) awarded Keystone Peer Review Organization, LLC (Kepro) a contract valued at $113 million to manage the commonwealth’s Cardinal Care Medicaid fee-for-service (FFS) service authorizations (SA) and specialty services and FFS medical processing. The contract encompasses SA for medical and behavioral health. The contract goes live November 1, 2023, and will run for five years, followed by the option for five 12-month extensions. Magellan’s Behavioral Health Services Administrator (BHSA) contract will end.

DMAS currently contracts with Magellan BHSA to process behavioral health service authorizations . . .