Majority Of Florida Medicaid MCOs Cover 10 Or More ‘In Lieu-Of-Services’

Of the 15 Florida Medicaid managed care organization (MCO) plans, 13 are covering 10 or more of the state's 18 “in-lieu of services” (ILOS) as of October 2021 to reduce beneficiary utilization of emergency department services and hospitalization.  Of the other two plans, one covered two ILOS and the other covered five. ILOS are alternative services or settings to Medicaid state plan services. The state's MCOs can cover four of the 18 ILOS without approval from the Florida Agency for Health Care Administration (AHCA), and the remaining 14 need AHCA approval.

ILOS are optional medically appropriate, but . . .