2025 Clinical Practice Guidelines
Clinical practice guidelines are designed to guide decisions about diagnosing and treating specific health conditions. These guidelines are based on scientific evidence, medical literature reviews, or established authority. All recommendations are grounded in published guidelines and do not prioritize treatments based solely on cost.
These guidelines serve as a guide for clinical decision-making, but clinicians and patients must collaborate to create individualized treatment plans tailored to each patient's unique needs and circumstances.
Molina Healthcare regularly reviews and updates these guidelines as new clinical evidence emerges. After review and necessary modifications by the Quality Improvement and Health Equity Transformation Committee, providers are notified of any changes via fax and/or mail.
To request a copy of any guideline, please contact Molina Healthcare Provider Services.
The guidelines listed below were reviewed and adopted by the Molina Healthcare National Quality Improvement and Health Equity Transformation Committee, with approval dates indicated for 2023 and beyond. All guidelines undergo monthly reviews and receive annual approval unless otherwise noted.
It's important to note that clinical guidelines are not used by Molina to determine benefit coverage. Instead, they are educational tools to aid clinical decision-making and are not considered a standard of care. Physicians should adapt the guidelines based on their clinical judgment.
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: June 2023
Molina adopted/reviewed: January 2023, February 2024, January 2025
Anxiety/Panic Disorder
Molina Healthcare has adopted the guideline for Anxiety/Panic Disorder from the American Academy of Clinical Psychiatrists.
The Clinical Practice Guideline may be accessed HERE.
Published: February 2021
Revised: February 2024
Molina adopted/reviewed: January 2023, February 2024, January 2025
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: January 2007
Revised: February 2021
Molina adopted/reviewed: January 2023, February 2024, January 2025
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: January 2023, February 2024, January 2025
Autism
Molina Healthcare has adopted the guideline for Identification, Evaluation, and Management of Children with Autism Spectrum Disorder from The American Academy of Pediatrics.
The Clinical Practice Guideline may be accessed HERE.
Published: January 2020
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, January 2025
Bipolar Disorder
Molina Healthcare has adopted the guideline for Bipolar Disorder from the Department of Veterans Affairs & Department of Defense.
The Clinical Practice Guideline may be accessed HERE.
Published: May 2023
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, January 2025
Cancer
Molina Healthcare has adopted the guideline for Cancer from The National Comprehensive Cancer Network® (NCCN®).
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: January 2025
Children with Special Health Care Needs
Molina Healthcare has adopted the guideline for Access to Services for Children and Youth with Special Health Care Needs from The American Academy of Pediatrics.
The Clinical Practice Guideline may be accessed HERE.
Published: June 2022
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, January 2025
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 2024
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, January 2025
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: January 2025
Molina adopted/reviewed: January 2023, February 2024, January 2025
Depression
Molina Healthcare has adopted the guideline for VA/VOD Clinical Practice Guideline for the Management of Major Depressive Disorder from the Department of Veterans Affairs & Department of Defense.
The Clinical Practice Guideline may be accessed HERE.
Published: February 2022
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, January 2025
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 2025
Molina adopted/reviewed: January 2023, February 2024, January 2025
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.
Published: 2013
Revised: May 2022
Molina adopted/reviewed: January 2023, February 2024, January 2025
You may also visit the web site below for more information.
American College of Cardiology:HERE.
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: January 2023, February 2024, January 2025
You may also visit the web site below for more information.
National Health Care for Homeless Council:HERE.
HIV/AIDS
Molina Healthcare has adopted the guideline for Use of Antiretroviral Agents in Adults and Adolescents with HIV from the Department of Health and Human Services.
The Clinical Practice Guideline may be accessed HERE.
Published: April 2015
Revised: September 2024
Molina adopted/reviewed: September 2024, January 2025
Molina Healthcare has adopted the guideline for HIV/AIDS from the National Center for Biotechnology Information.
The Clinical Practice Guideline may be accessed HERE.
Published: January 2024
Revised: July 2024
Molina adopted/reviewed: September 2024, January 2025
You may also visit the web site below for more information.
Clinical Practice Guidelines for HIV/AIDS: HERE.
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: May 2018
Molina adopted/reviewed: January 2023, February 2024, January 2025
Obesity and Weight Management
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: January 2023, February 2024, January 2025
Molina Healthcare has adopted the guideline for Obesity and Weight Management from
The American Academy of Pediatrics (AAP)
The Journal of Obesity and Metabolic Syndrome
The National Institute of Health (NIH)
The American Psychological Association (APA)
The Clinical Practice Guidelines may be accessed below:
Preventing Obesity and Eating Disorders in Adolescents HERE.
Published: September 2016
Revised: June 2022
Molina adopted/reviewed: January 2025
Clinical Practice Guideline for Multicomponent Behavioral Treatment of Obesity and Overweight in Children and Adolescents HERE.
Published: March 2018
Revised: N/A
Molina adopted/reviewed: January 2025
Obesity in Adults: clinical practice guideline HERE.
Published: August 2020
Revised: N/A
Molina adopted/reviewed: January 2025
You may also visit the below websites for additional information on Obesity and Weight Management:
American Academy of Pediatrics (AAP) - HERE.
National Institute of Health (NIH) - HERE.
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 accessedHERE.
Published: June 2015
Revised: January 2020
Molina adopted/reviewed: January 2023, February 2024, January 2025
Molina Healthcare has adopted the guideline CDC Guideline for Prescribing Opioids for Chronic Pain from the Centers for Disease Control and Prevention
The Clinical Practice Guideline may be accessed HERE.
Published: March 2016
Revised: November 2022
Molina adopted/reviewed: January 2023, February 2024, January 2025
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: January 2023, February 2024 , January 2025
Postpartum Care
Molina Healthcare has adopted the guideline for Postpartum Care from The American College of Obstetricians and Gynecologists.
The Clinical Practice Guideline may be accessed HERE.
Published: June 2016
Revised: May 2018
Molina adopted/reviewed: January 2025
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: January 2023, February 2024, January 2025
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: January 2023, February 2024, January 2025
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: January 2020
Molina adopted/reviewed: July 2017, March 2018, April 2019, March 2020, March 2021, April 2022, January 2023, February 2024, January 2025
You may also visit the below websites for additional information on Sickle Cell Disease:
American Society of Hematology - HERE.
Centers for Disease Control and Prevention - HERE.
Substance Use Disorder
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: January 2023, February 2024, January 2025
Suicide Prevention
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: April 2024
Molina adopted/reviewed: January 2023, February 2024, July 2024, January 2025
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: January 2023, February 2024, January 2025