By OPEN MINDS Circle
Acentra Health, formerly known as Kepro, announced on September 7, 2023, that it was awarded a five-year contract with the Florida Agency for Health Care Administration (AHCA) to continue overseeing utilization management services for Medicaid fee-for-service (FFS) beneficiaries. Acentra will also provide utilization review for certain Medicaid managed care carve-outs, including behavior analysis and prescribed pediatric extended care (PPEC). Acentra will also maintain a call center and will conduct outreach with provider organizations and beneficiaries. The contract includes five option years.
AHCA has contracted with Kepro for this service for the past 12 years. The contract originated in 2011 under eQHealth Solutions, LLC, which was acquired by Kepro on October 1, 2021, in a merger with CNSI. The joined company rebranded as Acentra Health in June 2023. The acquisition expanded Kepro’s population health management and technology solution portfolios.
The Florida contract services span 18 areas of utilization review for the FFS Medicaid program covering one million beneficiaries. The services include inpatient acute medical surgical and psychiatric services, and enhanced care coordination for beneficiaries receiving select services. The PPEC service provides continual skilled medical care in a community setting for medically complex children up to age 20.
Acentra Health has 34 state Medicaid contracts for utilization and care management. The company holds URAC accreditation for health utilization management. In total, it serves more than 300 clients in all 50 states including federal, state, and local governments. The company manages and processes over 1.5 billion claims and encounters and disburses over $26 billion in payments annually.
For more information, contact:
- Bailey Smith, Communications Director, Florida Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, Florida 32308; 850-412-3623; Email: AHCACommunications@ahca.myflorida.com; Website: https://ahca.myflorida.com; and https://fl.eqhs.com/
- Janice Moore, Vice President, Corporate Communications, Acentra Health, 1600 Tysons Boulevard, Suite 1000, McLean, Virginia 22102; 703-214-3552; Email: Janice.moore@acentra.com; Website: https://acentra.com/