Molinalogo

The guidelines below were reviewed and adopted by the Molina Healthcare National Quality Improvement and Health Equity Transformation Committee. Committee approval dates are shown for 2015 and beyond. All guidelines are reviewed monthly by the National Quality Improvement and Health Equity Transformation Committee and are approved annually unless otherwise noted.

Clinical guidelines are not used by Senior Whole Health of New York (SWH of NY) 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)

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Anxiety/Panic Disorder

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Asthma

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Attention Deficit Hyperactivity Disorder (ADHD)

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023 

 

Autism

Senior Whole Health 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

SWH of NY adopted/reviewed: September 2021, April 2022, January 2023

Bipolar Disorder

Senior Whole Health has adopted the guideline for Bipolar Disorder from the American Psychiatric Association.

The Clinical Practice Guideline may be accessed here.

Published: April 2002

Revised: 2010

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Children with Special Health Care Needs
 

Senior Whole Health 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

SWH of NY adopted/reviewed: August 2021, April 2022, January 2023

 

Chronic Kidney Disease

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

 

Chronic Obstructive Pulmonary Disease

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, January 2022, April 2022, January 2023

Depression

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Diabetes

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, February 2022, April 2022, January 2023

Heart Failure in Adults

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, July 2022, January 2023

 

Homelessness - Special Health Care Needs

Senior Whole Health 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

SWH of NY adopted/reviewed: September 2021, April 2022, January 2023

 

Hypertension

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Obesity

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Opioid Management

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Senior Whole Health has adopted the guideline CDC Guideline for Prescribing Opioids for Chronic Pain.

The Clinical Practice Guideline may be accessed here.

Published: March 2016

Revised: N/A

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Perinatal Care

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Pregnancy Management

Senior Whole Health 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 2020

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Schizophrenia

Senior Whole Health has adopted the guideline for Schizophrenia from the American Psychiatric Association,

The Clinical Practice Guideline may be accessed here.

Published: 2021

Revised: N/A

SWH of NY adopted/reviewed: April 2021, April 2022, January 2023

Sickle Cell Disease

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

Substance Abuse Treatment

Senior Whole Health 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

SWH of NY adopted/reviewed: March 2021, April 2022, January 2023

 

Suicide Risk

Senior Whole Health 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

SWH of NY adopted/reviewed: August 2021, April 2022, January 2023

 

Trauma-Informed Primary Care
 

Senior Whole Health 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

SWH of NY adopted/reviewed: August 2021, April 2022, January 2023