Preventive health guidelines can be beneficial to the provider and his/her patients. Guidelines are based on scientific evidence, review of the medical literature, or appropriately established authority, as cited. All recommendations are based on published consensus guidelines and do not favor any particular treatment based solely on cost considerations.
These guidelines are meant to recommend a standard level of care and do not preclude the delivery of additional preventive services depending on the individual needs of the patient.
Molina Healthcare reviews and revises guidelines as clinical evidence is updated. Once the guidelines have been reviewed and modified as needed by a dedicated Quality Improvement Committee, Molina Healthcare providers will be notified of any changes and updates by fax and/or mail.
To request a copy of any guideline, please call Molina Healthcare Provider Services.
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.
Adult Preventive Services Recommendations
Molina Healthcare has adopted the guideline for Adult Preventive Services Recommendations from U.S. Preventive Services Task Force.
The Clinical Practice Guideline may be accessed HERE.
Published: 2013
Revised: June 2024
Molina adopted/reviewed: March 2015, March 2016, October 2017, March 2018, April 2019, March 2020, March 2021, July 2021, August 2021, April 2022, October 2022, November 2022, January 2023, February 2024
Recent updates recommended include the following:
- Screening for Hepatitis B (Revised December 2020)
- Tobacco Smoking Cessation in Adults, interventions including pregnant/nonpregnant adults (Revised January 2021)
- Lung Cancer: Screening: aged 50-80 years with a 20 pack-year smoking history and currently smoke or have quit within the past 15 years (Revised March 2021)
- Screening for Hypertension: 18 years or older without known hypertension (Revised April 2021)
- Colorectal Cancer Screening: adults aged 45-49 & 50-75 years (Revised May 2021)
- Healthy Weight and Weight Gain in Pregnancy: Behavioral Counseling Interventions: pregnant persons (Revised May 2021)
- Gestational Diabetes Screening: asymptomatic pregnant persons at 24 weeks of gestation or after (Revised August 2021)
- Screening for Prediabetes and Type 2 Diabetes: asymptomatic adults aged 35-70 years who have overweight or obesity (Revised August 2021)
- Aspirin Use for Preventive Medication to prevent Preeclampsia and related Morbidity and Mortality (Revised September 2021)
- Chlamydia Screening: sexually active women, including pregnant persons (Revised September 2021)
- Gonorrhea Screening: sexually active women, including pregnant persons (Revised September 2021)
- Prevention of Dental Caries: Children younger than five: Screening and Interventions: Fluoride Varnish & Fluoride Supplementation (Revised December 2021)
- AHA Guideline for the Management of Heart Failure (Revised August 2022)
- Syphilis Infection in Nonpregnant Adolescents and Adults: Screening (Revised September 2022)
- Depression and Suicide Risk in Children and Adolescents: Screening (Revised October 2022)
- Anxiety in Children and Adolescents: Screening (Revised October 2022)
- Latent Tuberculosis Infection in Adults: Screening (Revised May 2023)
- Depression and Suicide Risk in Adults: Screening (Revised June 2023)
- Anxiety Disorders in Adults: Screening (Revised June 2023)
- Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication (Revised August 2023)
- Prevention of Acquisition of HIV: Preexposure Prophylaxis (Revised August 2023)
- Hypertensive Disorders of Pregnancy: Screening (Revised September 2023)
- Breast Cancer Screening (Revised April 2024)
- Falls Prevention in Community-Dwelling Older Adults: Interventions (Revised June 2024)
Recommendations for Preventive Pediatric Health Care
Molina Healthcare has adopted the guideline for Preventive Pediatric Health Care from Bright Futures/American Academy of Pediatrics.
The Clinical Practice Guideline may be accessed HERE.
Published: 2013
Revised: June 2024
Molina adopted/reviewed: March 2015, March 2016, October 2017, March 2018, April 2019, March 2020, March 2021, April 2022, July 2022, January 2023, April 2023, February 2024
Recent updates recommended include the following:
No current updates
Molina Healthcare has adopted the guideline for Pediatric/Adolescent Preventive Services Recommendations from U.S. Preventive Services Task Force.
The Clinical Practice Guideline may be accessed HERE.
Published: 2013
Revised: June 2024
Molina adopted/reviewed: August 2024
Recent updates recommended include the following:
- High Body Mass Index in Children and Adolescents: Interventions (Revised June 2024)
Recommended Adult Immunization Schedule for ages 19 Years or Older, United States, 2024
Molina Healthcare has adopted the guideline for Adult Immunization Schedule, 19 Years and Older, 2024 from Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessed HERE.
Published: 2014
Revised: June 2024
Molina adopted/reviewed: March 2015, March 2016, March 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023, February 2023, February 2024
Recent updates recommended include the following:
No current updates
Recommended Child and Adolescent Immunization Schedule for ages 18 Years and Younger, United States, 2024
Molina Healthcare has adopted the guideline for Recommended Child and Adolescent Immunization Schedule for ages 18 years and younger, 2024 from Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessed HERE.
Published: 2014
Revised: June 2024
Molina adopted/reviewed: March 2015, March 2016, March 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023, February 2023, February 2024
Recent updates recommended include the following:
No current updates