System Status

Our Services for Ohio Medicaid

Quality Management

KEPRO will be implementing and managing a statewide quality and hospital utilization control program for services provided to Ohio Medicaid consumers. We will also be reviewing and assessing the quality of care for services provided to Ohioans on Medicaid. KEPRO will be supporting the Ohio Department of Medicaid’s Bureau of Program Integrity’s quality effort.

Utilization Management

As part of KEPRO’s work on behalf of the Ohio Department of Medicaid, KEPRO will conduct utilization reviews, including focused reviews, prior authorizations, special reviews, retrospective reviews and pre-certification reviews.

In addition, KEPRO will provide reports and quality of care studies, as well as, provider education and technical assistance in policy development and operations.