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MedicaidAdministrativeMedium impact

BT202301: Kepro to serve as new fee-for-service IHCP prior authorization and utilization management vendor

Indiana Medicaid (IHCP)·IN·Prior Authorization
Effective date
Jul 1, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

Kepro will replace Gainwell Technologies as the new prior authorization and utilization management vendor for Indiana Health Coverage Programs fee-for-service effective July 1, 2023. This vendor change affects all prior authorization processes, Right Choices Program, and Traumatic Brain Injury program responsibilities.

Action Required

Action needed
Before July 1, 2023: Billing and prior authorization staff must prepare for transition to new PA-UM vendor Kepro. Monitor IHCP communications for training schedules, new contact information, and updated submission processes. Update internal documentation with new vendor contact details when provided.