Access to Guidelines 

Dear valued member & provider:

Medi-Cal Guidelines - All Provider Manuals

Medicare Guidelines - Medicare

Community Health Group utilizes Milliman Care Guidelines (MCG) when reviewing requests. A copy of the criteria will be provided upon request to the contracted and/or non-contracted providers.

Pediatric Preventive Care

American Academy of Pediatrics/Bright Futures - Pediatric Preventative Care Schedule

Adult Preventive Care

U.S. Preventative Services Task Force - Adult Preventive Health Care Schedule

Diabetes

American Diabetes Association – Diabetes Care

Chronic Obstructive Pulmonary Disease

Global Initiative for Chronic Obstructive Lung Disease - GOLD Report

Hypertension

American College of Cardiology Foundation/ American Heart Association - Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

Congestive Heart Failure

American Heart Association/ American College of Cardiology Foundation/ Heart Failure Society of America - Guideline for the Management of Heart Failure

Asthma

National Heart, Lung, and Blood Institute - Guidelines for the Diagnosis and Management of Asthma

Women’s Health

Women’s Preventative Services Initiative/ U.S. Preventive Services Task Force/ Bright Futures -Recommendations for Well-Woman Care

Prenatal Testing

American College of Obstetricians and Gynecologists - Screening for Fetal Chromosomal Abnormalities

American College of Obstetricians and Gynecologists - Prenatal Diagnostic Testing for Genetic Disorders

Human Immunodeficiency Virus

American College of Obstetricians and Gynecologists - Pre-Exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus

Chronic Pain

American Academy of Family Physicians/ Centers for Disease Control and Prevention - Opioid Prescribing for Chronic Pain

Substance Abuse Treatment

Substance Abuse and Mental Health Services Administration - Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings

General Wellness

American Lung Association - Getting Ready for Your Next Office Visit

Transgender Care

The World Professional Association for Transgender Health - Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

To request a free copy of the clinical guidelines used to make the decision please email us at: info@chgsd.com