Which of the following is NOT a form of Managed Care Organization (MCO)?

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Private Fee-for-Service (PFFS) Plans are not considered a form of Managed Care Organization (MCO). Instead, PFFS plans are a type of Medicare Advantage plan that allows beneficiaries more flexibility in choosing healthcare providers. In a PFFS plan, beneficiaries can see any provider that accepts the plan's payment terms, rather than being limited to a network of providers.

In contrast, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Exclusive Provider Organizations (EPO) all represent varying structures of managed care. These organizations typically require members to use a specific network of providers and may have more structured guidelines for managing care and controlling costs. HMOs often require referrals for specialist services and have lower out-of-pocket costs, while PPOs provide more flexibility in choosing healthcare providers, albeit typically at a higher cost. EPOs, like PPOs, offer a network of providers but do not require referrals; however, they do not cover out-of-network care except in emergencies.

This distinction highlights how PFFS plans operate outside of the managed care framework typical of MCOs.

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