Community Health Plan of Washington uses guidelines for chronic diseases (including medical and behavioral health conditions) and for preventive services. Reference is made to the pertinent evidence-based, peer-reviewed guidelines from Nationally recognized agencies.
The guidelines are intended to help guide providers in their care of our members including Medicare, Apple Health, Cascade Select, and Behavioral Health Services Only members. The guidelines also ensure that the Clinical Coverage Criteria used for utilization management decisions are aligned with the current evidence-based guidelines.
The following previously approved guidelines have been updated and re-approved by the Clinical Quality Improvement Committee (CQIC) on August 9, 2023. In addition, CQIC had adopted a CPG for lead screening.
Topic | Guideline Link |
Depression following coronary events | Depression Following Acute Coronary Syndrome Events: Screening and Treatment Guidelines from the AAFP |
Developmental Delay Screening | Developmental Delay: When and How to Screen |
Disabilities | Guidelines for Assessment of and Intervention with Persons with Disabilities |
Osteoporosis and Low Bone Density Screening | USPSTF: Osteoporosis to Prevent Fractures: Screening |
Otitis Media in Children | AAFP Guidelines on Otitis Media in Children |
Immunizations | Vaccine Recommendations of the ACIP |
Lead Screening *NEW* |
Recommendations For Blood Lead Testing Of Children In Washington State |
Two CPGs were retired as they are no longer available from the host organization:
- AAFP Guideline for Cardiovascular Risk from 6/1/2014
- AHRQ Practice Guideline for the Use of Disease-modifying Antirheumatic Drugs and Biologic Agents in the Treatment of Rheumatoid Arthritis from 3/1/2017
The complete list of Clinical Practice Guidelines is located here.
(Guidelines last updated: August 28, 2023)