Clinical Practice Guidelines
Clinical practice guidelines are documents which seeks to guide decisions about the diagnosis and treatment of certain health conditions. Clinical practice guidelines are based on scientific evidence, review of the medical literature, or appropriately established authority. All recommendations are based on published agreed on guidelines and do not favor any treatment based solely on cost considerations.
The recommendations for care are suggested as guides for making clinical decisions. Clinicians and their patients must work together to develop individual treatment plans that are tailored to the specific needs and circumstances of each 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 of Mississippi.
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.
Antipsychotic Prescribing for Children and Adolescents
Molina Healthcare has adopted the guideline for Antipsychotic Prescribing for Children and Adolescents from the Substance Abuse and Mental Health Services Administration (SAMSHA).
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
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: N/A
Molina adopted/reviewed: January 2023, February 2024, December 2024
Immunizations: ≥ 19 Years of Age Immunization Schedule
Molina Healthcare has adopted the guideline for Immunizations: ≥ 19 Years of Age Immunization Schedule from the Advisory Committee on Immunization Practices (ACIP); Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
Immunizations: 0-18 Years of Age Immunization Schedule
Molina Healthcare has adopted the guideline for Immunizations: 0-18 Years of Age Immunization Schedule from the Advisory Committee on Immunization Practices (ACIP); Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
Asthma
Molina Healthcare has adopted the guideline for Diagnosis and Management of Asthma from the National Institute of Health (NIH): National Heart, Lung, and Blood Institute (NHLBI).
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, December 2024
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, December 2024
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, December 2024
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, December 2024
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: December 2024
Chronic Obstructive Pulmonary Disease
Molina Healthcare has adopted the guideline for Global Strategy for Prevention, Diagnosis, and Management of COPD from the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
The Clinical Practice Guideline may be accessed HERE.
Published: 2011
Revised: January 2024
Molina adopted/reviewed: January 2023, February 2024, December 2024
Coronary Artery Disease
Molina Healthcare has adopted the guideline for Coronary Artery Disease from the American College of Cardiology and American Heart Association Task Force on Clinical Practice Guidelines.
The Clinical Practice Guideline may be accessed HERE.
Published: September 2019
Revised: April 2020
Molina adopted/reviewed: December 2024
Dental Health
Molina Healthcare has adopted the guideline for Dental Health from The American Dental Association (ADA).
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
Depression
Molina Healthcare has adopted the guideline for Management of Major Depressive Disorder from the United States Department of Veteran Affairs (VA) and the Department of Defense (DoD)
The Clinical Practice Guideline may be accessed HERE.
Published: February 2022
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, December 2024
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 2024
Molina adopted/reviewed: January 2023, February 2024, December 2024
Heart Failure in Adults
Molina Healthcare has adopted the guideline for Management of Heart Failure from
The American College of Cardiology (ACC) Foundation
The American Heart Association (AHA) Task Force on Practice Guidelines
The Heart Failure Society of America (HFSA).
The Clinical Practice Guideline may be accessed HERE.
Published: 2013
Revised: May 2022
Molina adopted/reviewed: January 2023, February 2024. December 2024
HIV/AIDS
Molina Healthcare has adopted the guideline for HIV/AIDS from the Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
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, December 2024
Kidney Disease
Molina Healthcare has adopted the guideline for Evaluation and Management of Chronic Kidney Disease from the National Kidney Foundation, Kidney Disease Outcome Quality Initiative (NKF KDOQI).
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
Lead Toxicity
Molina Healthcare has adopted the guideline for Prevention of Lead Toxicity from The American Academy of Pediatrics, Council on Environmental Health.
The Clinical Practice Guideline may be accessed HERE.
Published: July 2016
Revised: April 2021
Molina adopted/reviewed: December 2024
Maternal Care
Molina Healthcare has adopted the guideline for Maternal Care from The American College of Obstetricians and Gynecologists, ACOG Committee Opinion
The Clinical Practice Guideline may be accessedHERE.
Published: February 2015
Revised: August 2019
Molina adopted/reviewed: December 2024
Obesity and Weight Management
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: December 2024
Managing Overweight and Obesity in Adults HERE.
Published: November 2013
Revised: N/A
Molina adopted/reviewed: December 2024
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: December 2024
Obesity in Adults: clinical practice guideline HERE.
Published: August 2020
Revised: N/A
Molina adopted/reviewed: December 2024
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) websites - HERE.
Opioid & Opioid Prescribing
Molina Healthcare has adopted the guideline for Prescribing Opioids for Pain from the Centers for Disease Control and Prevention.
The Clinical Practice Guideline may be accessedHERE.
Published: March 2016
Revised: November 2022
Molina adopted/reviewed: January 2023, February 2024, December 2024
Opioid Management-Treatment of Opioid Use Disorder
Molina Healthcare has adopted the guideline for Treatment of Opioid Use Disorder 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, December 2024
Oppositional Defiant Disorder
Molina Healthcare has adopted the guideline for Oppositional Defiant Disorder from the American Academy Of Child And Adolescent Psychiatry (AACAP).
The Clinical Practice Guideline may be accessed HERE.
Published: July 2007
Revised: N/A
Molina adopted/reviewed: December 2024
Perinatal Care
Molina Healthcare has adopted the guideline for Perinatal Care from the American Academy of Pediatrics and 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: N/A
Revised: N/A
Molina adopted/reviewed: January 2023, February 2024, December 2024
Periodicity Schedule
Molina Healthcare has adopted the guideline for Recommendations for Preventive Pediatric Health Care from the American Academy of Pediatrics Bright Futures.
The Clinical Practice Guideline may be accessed HERE.
Published: 2013
Revised: June 2024
Molina adopted/reviewed:January 2023, April 2023, February 2024
December 2024
Pneumonia
Molina Healthcare has adopted the guideline for Pneumonia from the Infectious Diseases Society of America (IDSA) and Pediatric Infectious Diseases Society (PIDS).
The Clinical Practice Guidelines may be accessed below:
Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society (2016) HERE.
Published: July 2016
Revised: N/A
Molina adopted/reviewed: December 2024
The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America (2011) HERE.
Published: October 2011
Revised: N/A
Molina adopted/reviewed: December 2024
Postpartum Care
Molina Healthcare has adopted the guideline for Postpartum Care from The American College of Obstetricians and Gynecologists, American Academy of Family Practitioners.
The Clinical Practice Guideline may be accessed HERE.
Published: June 2016
Revised: May 2018
Molina adopted/reviewed: December 2024
Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder
Molina Healthcare has adopted the guideline for Post-Traumatic Stress Disorder and Acute Stress Disorder Acute Stress and Post-Traumatic Stress Disorder from the United States Department of Veteran Affairs (VA) and the Department of Defense (DOD)
The Clinical Practice Guideline may be accessed HERE.
Published: June 2017
Revised: June 2023
Molina adopted/reviewed: January 2023, February 2024, December 2024
Preventive Pediatric Care: 0-21 Years of Age
Molina Healthcare has adopted the guideline for Recommendations for Preventive Pediatric Health Care from Bright Futures/American Academy of Pediatrics.
The Clinical Practice Guideline may be accessed HERE.
Published: April 2023
Revised: N/A
Molina adopted/reviewed: December 2024
Respiratory Illness
Molina Healthcare has adopted the guideline for Respiratory Illness
The Clinical Practice Guidelines may be accessed below:
The Institute for Clinical Systems Improvement (ICSI).
Diagnosis and Treatment of Respiratory Illness in Children and Adults HERE.
Published: September 2017
Revised: N/A
Molina adopted/reviewed: December 2024
The American Academy of Family Physicians (AAFP) - AFP by Topic: Respiratory Tract Infections: HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
The Centers for Disease Control and Prevention (CDC) - Adult and Pediatric Recommendations: HERE.
Published: N/A
Revised: N/A
Molina adopted/reviewed: December 2024
Schizophrenia
Molina Healthcare has adopted the guideline for Schizophrenia
The Clinical Practice Guidelines may be accessed below:
The American Psychiatric Association, American Academy Of Child And Adolescent Psychiatry (AACAP) - Practice Parameters for the Assessment and Treatment of Children and Adolescents with Schizophrenia HERE.
Published: September 2013
Revised: N/A
Molina adopted/reviewed: December 2024
American Academy Of Child And Adolescent Psychiatry (AACAP) - Practice Guideline for the Treatment of Patients with Schizophrenia HERE.
Published: September 2020
Revised: N/A
Molina adopted/reviewed: December 2024
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: January 2023, February 2024, December 2024
Substance use Disorder 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: January 2023, February 2024,December 2024
You may also visit practitioner training materials on the Substance Abuse and Mental Health Services Administration (SAMHSA) web site below for more information:HERE.
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: April 2024
Molina adopted/reviewed: January 2023, February 2024, December 2024
U.S Preventive Services Task Force Recommendations
Molina Healthcare has adopted the guideline for Pediatric and Adolescent Services Recommendations from U.S. Preventive Services Task Force.
The Clinical Practice Guideline may be accessed HERE.
Published: N/A
Revised: June 2024
Molina adopted/reviewed: August 2024, December 2024
Adult Vision Screening
Molina Healthcare has adopted the guideline for Adult Vision Screening from the American Optometric Association.
The Clinical Practice Guideline may be accessed HERE.
Published: January 2023
Revised: N/A
Molina adopted/reviewed: December 2024
Pediatric Vision Screening
Molina Healthcare has adopted the guideline for Pediatric Vision Screening from the American Optometric Association.
The Clinical Practice Guideline may be accessed HERE.
Published: February 2017
Revised: N/A
Molina adopted/reviewed: December 2024