Quality Measures

• HEDIS®
• HEDIS® Standards of Care

Standards, Guidelines and Program Descriptions

The guidelines below are updated every two years or with changes and mailed to providers. Please call 1.800.624.6961, ext. 7559 if you require another set of guidelines we mail them out to you.

Quality Improvement

• Standards for Access to Care & Services (updated 7.5.18)
• Guidelines for Patient Records (updated 6.26.18)
• Guidelines for Preventative Health Services (updated 6.5.18)
• Guidelines for the Management of Asthma (updated 1.30.19)

Disease Management

• Disease Management Program Description
• COPD Guidelines (updated 9.26.18)
• Guidelines for Management of Congestive Heart Failure (updated 4.17.18)
• Guidelines for the Management of Diabetes Mellitus (updated 4.17.18)
• Guidelines for Perinatal Care (updated 6.19.17)
  • Perinatal Care Preventive Health Guidelines
• Guidelines for the Management of Coronary Artery Disease (updated 8.23.18)
  • 2017 Revascularization in Stable Ischemic Heart Disease
  • 2017 Guidelines for Adults with ST-Elevation and Non-ST-Elevation Myocardial Infarction

Behavioral Health

• ADHD Guidelines (updated 1.30.19)
• Guidelines for the Management of Depression (1.30.19)
• Guidelines for the Treatment of Substance Abuse (updated 4.17.18)