FamilyCare recognizes the use of clinical guidelines to help direct providers to the most current, evidence-based standards in health care. While FamilyCare strives to cover guideline recommended treatments for covered conditions, coverage is dependent on benefits. For Medicaid these are established by OHP, the Prioritized List and/or FamilyCare policies or formulary. For Medicare this is outlined in the Evidence of Coverage for individual plans. Guidelines are put forth by many organizations, and FamilyCare acknowledges there may be multiple valid guidelines for conditions. The endorsement of the following guidelines does not imply unique authority of listed guidelines, rather are listed as a starting point for providers wishing to review current recommendations. An excellent resource for clinical guidelines is the National Guideline Clearinghouse provided by AHRQ, located at www.guideline.gov.
ASTHMA FamilyCare recommends the following guidelines: Asthma
DIABETES FamilyCare recommends the Guideline issued by the American Diabetic Association (currently the 2010 Clinical Practice Recommendations) at the American Diabetic website under “For Professionals”:Diabetes Journals
