Clinical Practice Guidelines

Evidence Based Clinical Practice Guidelines

Disease Process
Guidelines

Asthma

CDC’s National Asthma Control Program, 12/2022.
Guidelines for the Diagnosis and Management of Asthma

Global Strategy for Asthma Management and Prevention – Global Initiative for Asthma, 2023.
Global Strategy for Asthma Management and Prevention

Behavioral Health

Delegated MBHO continually reviews and adopts guidelines that meet the new standards for guideline rigor and transparency.
Clinical Guidelines: Carelon Behavioral Health Options

Cancer

National Comprehensive Cancer Network: Breast 03/23/2023; Prostate 07/17/2023; Colon 04/25/2023; Rectal 05/26/2023.
Clinical Practice Guidelines in Oncology

American Cancer Society, Guidelines for the Early Detection of Cancer (Last Revised 02/24/2023).
Guidelines for the Early Detection of Cancer

Cardiovascular Disease

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, September 2019.
Guidelines on the Primary Prevention of Cardiovascular Disease

2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines, November 2018.
Guidelines on the Management of Blood Cholesterol

Chronic Obstructive Pulmonary Disease (COPD)

Global Initiative for Chronic Obstructive Lung Disease (GOLD); 2023 GOLD Reports - 2023 Global Strategy for Prevention, Diagnosis and Management of COPD.
Diagnosis, Management and Prevention of COPD

Congestive Heart Failure (CHF)

2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. April 2017.
Management of Heart Failure

2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. February 2021.
Optimization of Heart Failure Treatment

Diabetes

Standards of Medical Care in Diabetes – American Diabetes Association, January 2023.
The Standards of Medical Care in Diabetes

HIV – Adult

HIV – Adult Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV, July 2016; Last Reviewed & Updated 03/23/2023.
Use of Antiretroviral Agents in Adults and Adolescents Living with HIV

Hypertension

2020 International Society of Hypertension Global Hypertension Practice Guidelines, May 6, 2020.
Hypertension Guidelines

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, updated 5/2018.
Prevention, Detection, Evaluation, and Management of High Blood Pressure

Preventive Health

Recommendations of the U.S. Preventive Services Task Force.
Preventive Health Services Recommendations


Disclaimer Statement

Clinical health guidelines are referenced or provided by Optimum Healthcare for informational purposes only. Clinical health guidelines do not constitute legal or medical advice. Treating physicians or other health care professionals are solely responsible for diagnoses, treatment, and medical advice in accordance with their own professional judgment. Treating physicians or other health care professionals have the responsibility to submit claims or invoices for payment only for treatments that are appropriate and medically necessary. Coverage decisions are subject to all terms and conditions of the applicable benefit plan, and clinical guidelines do not constitute plan authorization, a guarantee of coverage, or an explanation of benefits. Patients should discuss the information in the clinical guidelines with their treating health care professionals.

These clinical guidelines are subject to change without notice and may not represent the most current information available. Optimum Healthcare makes no warranties or guarantees concerning or related to these guidelines, and will not be held liable for any deficiencies with regard to guidelines either referenced or not referenced, or for any inaccuracies or recommendations made by independent third parties who have relied on this information.

Last updated 10/01/2023