2021 Clinical Practice Guidelines

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee.

Clinical guidelines are not used by Molina to decide benefit coverage. The guidelines are an educational tool to aid clinical decision-making. They are not a standard of care. The physician should adapt the guideline when clinical judgment so indicates.


Acute Stress and Post-Traumatic Stress Disorder (PTSD)

Molina Healthcare has adopted the guideline for Acute Stress and Post-Traumatic Stress Disorder from the Department of Veterans Affairs & Department of Defense.

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Anxiety/Panic Disorder

Molina Healthcare has adopted the guideline for Anxiety/Panic Disorder from the American Psychiatric Association.

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Asthma

Molina Healthcare has adopted the Guidelines for the Diagnosis and Management of Asthma (EPR-3) from the National Institute of Health (NIH): National Heart, Lung, and Blood Institute (NHLBI).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Attention Deficit Hyperactivity Disorder (ADHD)

Molina Healthcare has adopted the Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit Hyperactivity Disorder in Children and Adolescents from the Journal of the American Academy of Pediatrics (AAP).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Bipolar Disorder

Molina Healthcare has adopted the guideline for Bipolar Disorder from the American Psychiatric Association.

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Chronic Kidney Disease

Molina Healthcare has adopted the Evaluation and Management of Chronic Kidney Disease Guideline from the National Kidney Foundation, Kidney Disease Outcome Quality Initiative (NKF KDOQI).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.

 

Chronic Obstructive Pulmonary Disease

Molina Healthcare adopted the Global Strategy for Diagnosis, Management, and Prevention of COPD from the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Depression

Molina Healthcare has adopted the Treatment of Patients with Major Depressive Disorder with the Guideline from the American Psychiatric Association (APA).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Diabetes

Molina Healthcare has adopted the guideline for Diabetes from the American Diabetes Association (ADA).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Heart Failure in Adults

Molina Healthcare has adopted the Guideline for the Management of Heart Failure from the American College of Cardiology (ACA).

The Clinical Practice Guideline may be accessed here.

You may also visit the web site below for more information. 

American College of Cardiology: here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Hypertension

Molina Healthcare has adopted the Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults from the American College of Cardiology.

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Obesity

Molina Healthcare has adopted the Guidelines for the Comprehensive Medical Care of Patients with Obesity from the American Association of Clinical Endocrinologists (AACE).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Opioid Management

Molina Healthcare has adopted the Use of Medications in the Treatment of Addiction Involving Opioid Use Guideline from the American Society of Addiction Medicine (ASAM).

The Clinical Practice Guideline may be accessed here.

Molina Healthcare has adopted the CDC Guideline for Prescribing Opioids for Chronic Pain.

The Clinical Practice Guideline may be accessed here.

The above guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Perinatal Care

Molina Healthcare has adopted the Guidelines for Perinatal Care from the American College of Obstetricians and Gynecologists.

The Clinical Practice Guideline may be accessed here - Guidelines can be reviewed by ACOG members only using a secure password.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Pregnancy Management

Molina Healthcare has adopted the Guidelines for Routine Prenatal and Postnatal Care from Michigan Quality Improvement Consortium.

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Schizophrenia

Molina Healthcare has adopted the guideline for Schizophrenia from the American Psychiatric Association,

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee April 2021.


Sickle Cell Disease

Molina Healthcare has adopted the Management of Sickle Cell Disease Guideline from the National Heart, Lung, and Blood Institute (NHLBI).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.


Substance Abuse Treatment

Molina Healthcare has adopted the Guidelines for Detoxification and Substance Abuse Treatment from the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Clinical Practice Guideline may be accessed here.

The guidelines were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee March 2021.