Clinical Practice Guidelines
The guidelines below were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee. Committee approval dates are shown for 2015 and beyond. All guidelines are reviewed monthly by the National Quality Improvement Committee and are approved annually unless otherwise noted.
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.
Published: June 2017
Revised: N/A
Molina adopted/reviewed: March 2020, March 2021, April 2022, January 2023
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.
Published: January 2009
Revised: N/A
Molina adopted/reviewed: March 2020, March 2021, April 2022, January 2023
Asthma
Molina Healthcare has adopted the guideline for 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.
Published: July 2007
Revised: December 2020
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Attention Deficit Hyperactivity Disorder (ADHD)
Molina Healthcare has adopted the guideline for 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.
Published: November 2011
Revised: October 2019
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Autism
Molina Healthcare has adopted the guideline for Identification, Evaluation, and Management of Children With Autism Spectrum Disorder from the The American Academy of Pediatrics.
The Clinical Practice Guideline may be accessed here.
Published: January 2020
Revised: N/A
Molina adopted/reviewed: September 2021, April 2022, January 2023
Bipolar Disorder
Molina Healthcare has adopted the guideline for Bipolar Disorder from the American Psychiatric Association.
The Clinical Practice Guideline may be accessed here.
Published: April 2002
Revised: N/A
Molina adopted/reviewed: March 2020, March 2021, April 2022, January 2023
Children with Special Health Care Needs
Molina Healthcare has adopted the guideline for Promoting Health for Children and Youth with Special Health Care Needs from Bright Futures.
The Clinical Practice Guideline may be accessed here.
Published: 2017
Revised: N/A
Molina adopted/reviewed: August 2021, April 2022, January 2023
Chronic Kidney Disease
Molina Healthcare has adopted the guideline for 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.
Published: March 2014
Revised: N/A
Molina adopted/reviewed: July 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Chronic Obstructive Pulmonary Disease
Molina Healthcare has adopted the guideline for 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.
Published: 2011
Revised: December 2022
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, February 2019, April 2019, March 2020, March 2021, January 2022, April 2022, January 2023
Depression
Molina Healthcare has adopted the guideline for Treatment of Patients with Major Depressive Disorder from the American Psychiatric Association (APA).
The Clinical Practice Guideline may be accessed here.
Published: October 2010
Revised: N/A
Molina adopted/reviewed: March 2015, March 2016, August 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Diabetes
Molina Healthcare has adopted the guideline for Diabetes from the American Diabetes Association (ADA).
The Clinical Practice Guideline may be accessed here.
Published: January 2015
Revised: January 2023
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, February 2019, April 2019, March 2020, March 2021, February 2022, April 2022, January 2023
Heart Failure in Adults
Molina Healthcare has adopted the guideline for 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.
Published: 2013
Revised: May 2022
Molina adopted/reviewed: March 2015, March 2016, August 2017, March 2018, April 2019, March 2020, March 2021, April 2022, July 2022, January 2023
Homelessness - Special Health Care Needs
Molina Healthcare has adopted the guideline for Adapting Your General Recommendations for the Care of Homeless Patients from the National Health Care for the Homeless Council.
The Clinical Practice Guideline may be accessed here.
Published: 2010
Revised: N/A
Molina adopted/reviewed: September 2021, April 2022, January 2023
Hypertension
Molina Healthcare has adopted the guideline for 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.
Published: February 2014
Revised: August 2018
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, February 2019, April 2019, March 2020, March 2021, April 2022, January 2023
Obesity
Molina Healthcare has adopted the guideline for Comprehensive Medical Care of Patients with Obesity from the American Association of Clinical Endocrinologists (AACE).
The Clinical Practice Guideline may be accessed here.
Published: July 2016
Revised: N/A
Molina adopted/reviewed: March 2015, March 2016, February 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Opioid Management
Molina Healthcare has adopted the guideline for Use of Medications in the Treatment of Addiction Involving Opioids from the American Society of Addiction Medicine (ASAM).
The Clinical Practice Guideline may be accessed here.
Published: June 2015
Revised: January 2020
Molina adopted/reviewed: July 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Molina Healthcare has adopted the guideline CDC Guideline for Prescribing Opioids for Chronic Pain.
The Clinical Practice Guideline may be accessed here.
Published: March 2016
Revised: November 2022
Molina adopted/reviewed: April 2019, March 2020, March 2021, April 2022, November 2022, January 2023
Perinatal Care
Molina Healthcare has adopted the guideline 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.
Published: July 2012
Revised: September 2017
Molina adopted/reviewed: March 2015, March 2016, February 2017, November 2017, March 2018, February 2019, April 2019, March 2020, March 2021, April 2022, January 2023
Pregnancy Management
Molina Healthcare has adopted the guideline for Routine Prenatal and Postnatal Care from Michigan Quality Improvement Consortium.
The Clinical Practice Guideline may be accessed here.
Published: 2018
Revised: June 2022
Molina adopted/reviewed: April 2019, March 2020, March 2021, April 2022, October 2022, January 2023
Schizophrenia
Molina Healthcare has adopted the guideline for Schizophrenia from the American Psychiatric Association,
The Clinical Practice Guideline may be accessed here.
Published: 2021
Revised: N/A
Molina adopted/reviewed: April 2021, April 2022, January 2023
Sickle Cell Disease
Molina Healthcare has adopted the guideline for Management of Sickle Cell Disease from the National Heart, Lung, and Blood Institute (NHLBI).
The Clinical Practice Guideline may be accessed here.
Published: December 2014
Revised: N/A
Molina adopted/reviewed: July 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Substance Abuse Treatment
Molina Healthcare has adopted the guideline for Detoxification and Substance Abuse Treatment from the Substance Abuse and Mental Health Services Administration (SAMHSA).
The Clinical Practice Guideline may be accessed here.
Published: October 2015
Revised: N/A
Molina adopted/reviewed: July 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023
Suicide Risk
Molina Healthcare has adopted the guideline for Assessment and Management of Patients at Risk for Suicide from the Department of Veterans Affairs & Department of Defense.
The Clinical Practice Guideline may be accessed here.
Published: May 2019
Revised: N/A
Molina adopted/reviewed: August 2021, April 2022, January 2023
Trauma-Informed Primary Care
Molina Healthcare has adopted the guideline for Fostering Resilience and Recovery: A Change Package for Advancing Trauma-Informed Primary Care from The National Council for Mental Wellbeing.
The Clinical Practice Guideline may be accessed here.
Published: November 2019
Revised: N/A
Molina adopted/reviewed: August 2021, April 2022, January 2023