Clinical practice guidelines are designed to guide providers in diagnosing, treating, and promoting wellness for patients and can be beneficial for both providers and patients. These guidelines are based on scientific evidence, medical literature reviews, and/or established authority. Recommendations are grounded in published consensus guidelines and do not prioritize treatments solely based on cost.
Clinical practice guidelines serve as educational tools to aid clinical decision-making, but they are not intended to define a standard of care or determine benefit coverage. Clinicians should use their clinical judgment to adapt recommendations to each patient’s unique needs and circumstances and collaborate with the patient to create individualized treatment plans.
Molina Healthcare reviews guidelines on a quarterly basis and makes updates as new evidence emerges. All guidelines are presented to the National Quality Improvement and Health Outcomes Committee (NQI-HOC) for approval and adoption.
To request a copy of any guidelines, please contact Molina Healthcare Provider Services.