Clinical Practice Guidelines

The practice guidelines included on this website are not intended to be required treatment protocols. Physicians and other health professionals must rely on their own expertise in evaluating and treating patients. Practice guidelines are not a substitute for the best professional judgment of physicians and other health professionals.

Behavioral health guidelines may include commentary developed by the Company's behavioral health committees. Further, while authoritative sources are consulted in the development of these guidelines, the practice guideline may differ in some respects from the sources cited.

With respect to the issue of coverage, each patient should review his/her Policy or Certificate and Schedule of Benefits for details concerning benefits, procedures and exclusions prior to receiving treatment. The practice guidelines do not supersede the Policy or Certificate and Schedule of Benefits.

Asthma (reviewed 5/11)

• Guidelines for the Diagnosis and Management of Asthma (EPR 3 Summary Report 2007)

Chlamydia (reviewed 2/12, approved 3/12)

Centers for Disease Control and Prevention (CDC)

• 2010 STD Treatment Guidelines

Chronic Heart Failure (CHF) (in the Adult) (reviewed 5/11)

American Heart Association/American College of Cardiology

• 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

Chronic Obstructive Pulmonary Disease (COPD) (reviewed 2/12, approved 3/12)

Global Initiative for Chronic Obstructive Pulmonary Disease

• Global Strategy for Diagnosis, Management, and Prevention of COPD - December 2011

Coronary Artery Disease (CAD) (reviewed 5/11)

American Heart Association /American College of Cardiology

• AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2006 Update. Endorsed by the NHLBI. Circulation. May 2006; 113:2363-2372

American Heart Association/American College of Cardiology

• Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation 2007;115;2761-2788
• Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women 2011 Update: A Guideline from the American Heart Association. Circulation 2011; 123; 1243-1262; originally published online February 14, 2011.

Diabetes (reviewed 2/12, approved 3/12)

• 2012 Standards of Care and Clinical Practice Recommendations

High Blood Cholesterol (reviewed 9/11)

National Institutes of Health (NIH)

• Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

Human Papillomavirus (HPV) (reviewed 2/12)

Centers for Disease Control and Prevention (CDC)

• Sexually Transmitted Diseases - Treatment guidelines 2010 (Human Papillomavirus Infections)

Hypertension (High Blood Pressure) (reviewed 9/11)

National Heart, Lung, and Blood Institute

• High Blood Pressure Guidelines (JNC 7)

Maternity & Perinatal (reviewed 2/12, approved 3/12)

• Summary of Perinatal Care Guidelines
  • Perinatal Guideline Summary based on the Guidelines for Perinatal Care, 6th Edition, 2007
  • American Academy of Pediatrics (AAP)
  • The American College of Obstetricians and Gynecologists (ACOG)  
  • One change made to the Summary listed below was “added Chlamydia under the “Initial Prenatal Visit” column; Row “Testing”