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Clinical Practice Guidelines

Clinical practice guidelines are a resource for Humana-contracted physicians. The following guidelines are approved by Humana's medical directors:

Asthma Care

National Asthma Education and Prevention Program (NAEPP) Expert Panel Report 3 – Guidelines for the Diagnosis and Management of Asthma – Update on Selected Topics, July 2007
http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

Atherosclerotic Cardiovascular Disease

American Heart Association (AHA)/American College of Cardiology (ACC) Guidelines for Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update
http://content.onlinejacc.org/cgi/content/short/j.jacc.2011.10.824v1

COPD

Global Initiative for Chronic Obstructive Lung Disease (GOLD)'s Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (COPD), December 2011
http://www.goldcopd.org

Diabetes

American Diabetes Association (ADA), Standards of Medical Care in Diabetes – Diabetes Care, January 2012; 35 (Supplement 1)http://care.diabetesjournals.org/content/35/Supplement_1

Heart Failure

American College of Cardiology Foundation (ACCF)/American Heart Asociation (AHA) 2009 Focused Update: Guidelines for the Diagnosis and Management of Heart Failure in Adults
http://content.onlinejacc.org/cgi/content/full/j.jacc.2008.11.009

Hypertension

National Heart Lung and Blood Institute (NHLBI) Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7), 2004
http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm

Immunizations – Recommended Adult Immunization Schedule

Centers for Disease Control and Prevention (CDC) – United States, 2012
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6104a9.htm

Immunizations – Recommended Immunization Schedules for Persons Aged 0 through 18 Years

Centers for Disease Control and Prevention (CDC) – United States, 2012
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6105a5.htm

Kidney Disease

National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF KDOQI) Guidelines and Commentaries
http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm

Medical Records Guidelines

Humana has adopted guidelines based on federal and state medical record documentation requirements.
http://apps.humana.com/marketing/documents.asp?file=1885858

Obesity Screening

Screening for Obesity in Adults; U.S. Preventive Services Task Force (USPSTF) – December 2003
http://www.ahrq.gov/clinic/3rduspstf/obesity/obesrr.htm

Preventive Care

Agency for Healthcare Research and Quality (AHRQ) Guide to Clinical Preventive Services, 2010-2011. Recommendations of the U.S. Preventive Services Task Force (USPSTF).
http://www.ahrq.gov/clinic/pocketgd.htm

Additional Preventive Care Guidelines from Specialty Organizations:

Cancer Screening Guidelines (All types)

Cancer Screening in the United States, 2012: A Review of Current American Cancer Society Guidelines and Current Issues in Cancer Screening
http://onlinelibrary.wiley.com/doi/10.3322/caac.20143/pdf

Primary Prevention Cardiovascular Disease

American Heart Association (AHA) Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update
http://circ.ahajournals.org/cgi/content/full/106/3/388

Colorectal Cancer Screening Guidelines

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline From the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology
http://www.gastrojournal.org/article/S0016-5085(08)00232-1/fulltext

Humana periodically monitors compliance with nationally recognized clinical practice guidelines to identify opportunities for improvement.

Note: Humana publishes medical guidelines from a number of well-respected national sources. These guidelines may have some differences in recommendations. Information contained in the guidelines is not a substitute for a health care professional's clinical judgment and is not always applicable to an individual. Therefore, the health care professional and patient should work in partnership in the decision-making process regarding the patient's treatment. Furthermore, using this information will not guarantee a specific outcome for each patient. None of the information in the guidelines is intended to interfere with or prohibit clinical decisions made by a treating health care professional regarding medically available treatment options for patients. Since publication of these guidelines is not a promise of coverage, individuals should review their coverage to determine benefits.

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