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Medicaid In Lieu of Services (ILOS)

‘We are providers’ - Partners NC Medicaid Direct Plan
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What are In Lieu of Services?
Partners Health Management offers special services called In Lieu of Services (ILOS). These services are safe, helpful and cost-effective substitutes for regular Medicaid services. They are designed to improve members’ health and meet their needs when other services are not available.

Do I have to use In Lieu of Services?
No. Members do not have to use these services. If you don’t want to use an ILOS, you can still get the regular services listed in the State’s Medicaid plan.

How In Lieu of Services Are Chosen

Partners works with the North Carolina Division of Health Benefits (DHB) to:

  • Identify service gaps (areas where current Medicaid services may not be enough).
  • Develop new services that meet those needs.
  • Make sure services are safe, helpful and not more expensive than regular Medicaid services.

A team of experts at Partners—including doctors, care managers, finance staff and provider support—reviews and helps design new ILOS services before asking the State for approval.

Once approved:

  • Providers are trained on how to offer the new service.
  • The service is added to the member and provider benefit plans.
  • The service is listed on the Partners website and shared through bulletins.

Changes to In Lieu of Services

If an ILOS is removed or changed:

  • Partners must first get approval from the State.
  • Members and providers will get a written notice by mail at least 30 days before the change.
  • Partners will update its website and materials to show any changes.
  • Members using the service will be offered other approved services.

Have Questions?

Call the Partners Provider Support Line at 1-877-864-1454.

Review Partners In Lieu of Services Policy (.pdf)

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