Provider : Cpgs

Clinical Practice Guidelines are best practice recommendations based on available clinical outcome and scientific evidence. WellCare Clinical Practice Guidelines reference expert professional and clinical society recommendations, ensuring that the guidelines contain the highest level of evidence-based content. Clinical Practice Guidelines are also used to guide efforts to improvement the quality of care in our membership. Click on the links below to view each Clinical Practice Guideline.

Click on the desired link below to open or download a copy of WellCare’s CCGs, which are sorted alphabetically. Guidelines listed as IN REVIEW are currently in the approval process; the date listed is the most current copy of the guideline.  Guidelines listed as REVISED have been reviewed and are current as of the date listed.

Note: A new template was approved for use by the Medical Policy Committee on 12/1/2011. Guidelines are in the process of being updated to reflect the change. 

For additional behavioral health guidelines, visit Magellean Health by clicking here. 

ADHD REVISED Decemer 2011

In June 2011, the Medical Policy Committee adopted the American Academy of Child and Adolescent Psychiatry practice parameter for ADHD. Click here to view.

Adult Preventive Health REVISED May 2011

Asthma REVISED June 2010

Cholesterol Management REVISED July 2010

Chronic Heart Failure REVISED July 2010

Chronic Kidney Disease REVISED February 2012

COPD IN REVIEW April 2010

Coronary Artery Disease REVISED December 2011

In March 2010, the Medical Policy Committee adopted the Institute for Clinical Systems Improvement health care guideline for Coronary Artery Disease. Click here to view.

Depressive Disorders in Children and Adolescents REVISED December 2011

In June 2011, the Medical Policy Committee adopted the American Academy of Child and Adolescent Psychiatry practice parameter for Depressive Disorders in Children and Adolescents. Click here to view.

Diabetes in Adults REVISED June 2010

Diabetes in Children REVISED June 2010

HIV Antiretroviral Treatment in Adults NEW December 2010

HIV Screening NEW December 2010

Hypertension REVISED December 2011

Imaging for Low Back Pain REVISED September 2010

Lead Exposure IN REVIEW April 2010

Major Depressive Disorders in Adults REVISED December 2011

In June 2010, the Medical Policy Committee adopted the American Psychiatric Association's Practice Guideline on Major Depressive Disorders in Adults. Click here to view.

Obesity in Adults REVISED July 2010

Obesity in Children REVISED July 2010

Osteoporosis REVISED July 2010

Pediatric Preventive Health REVISED May 2011

Pharyngitis REVISED October 2010

Preconception and Perinatal Care IN REVIEW March 2011

Rheumatoid Arthritis NEW December 2010

Schizophrenia REVISED December 2011

In December 2010, the Medical Policy Committee adopted the American Psychiatric Association's Practice Guideline on Schizophrenia. Click here to view.

Suicidal Behaviors REVISED December 2011

In December 2010, the Medical Policy Committee adopted the American Psychiatric Association's Practice Guideline on Suicidal Behaviors. Click here to view.

Legal Disclaimer:  Clinical practice guidelines made available by WellCare are informational in nature and are not a substitute for the professional medical judgment of treating physicians or other health care practitioners.  These guidelines are based on information available at the time and may not be updated with the most current information available at subsequent times. Individuals should consult with their physician(s) regarding the appropriateness of care or treatment options to meet their specific needs or medical condition.  Disclosure of clinical practice guidelines is not a guarantee of coverage. Members of WellCare health plans should consult their individual coverage documents for information regarding covered benefits.  WellCare does not offer medical advice or provide medical care, and therefore cannot guarantee any results or outcomes.  WellCare does not warrant or guarantee, and shall not be liable for any deficiencies in the information contained herein or for any inaccuracies or recommendations made by independent third parties from whom any of the information contained herein was obtained.