Guidelines adopted by Humana

Clinical practice guidelines are resources* for Humana participating physicians and other Humana-contracted healthcare professionals. Humana has adopted the following guidelines:

Adult immunizations
Centers for Disease Control and Prevention (CDC)
Recommended immunization schedule for adults aged 19 years or older, United States 2022

Asthma care
GINA ©2022 Global Initiative for Asthma, reprinted with permission. Available from www.ginasthma.org
2022 Global Initiative for Asthma (GINA)

Atrial fibrillation guidelines
AHA/ACC/Heart Rhythm Society
2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Back pain
Department of Veterans Affairs Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline for the Diagnosis and Treatment of Low Back Pain (2022)

Childhood immunizations
Centers for Disease Control and Prevention
Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2022

Childhood preventive services
American Academy of Pediatrics
Recommendations for Preventive Pediatric Health Care – Bright Futures Periodicity Table, PDF

Cholesterol treatment
Department of Veterans Affairs Department of Defense (VA/DoD)
The Management of Dyslipidemia for Cardiovascular Risk Reduction (2020)

Chronic obstructive pulmonary disease (COPD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
© 2022, 2023, Global Initiative for Chronic Obstructive Lung Disease, available from www.goldcopd.org, published in Deer Park, IL, USA.
Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (COPD), 2023 Report, PDF

COVID-19
National Institute of Health (NIH) COVID-19 Treatment Guidelines
(The NIH updates this guideline continually, as it obtains new information about managing COVID-19). The guideline is approved in its most current format.
Guideline for the Management of COVID-19

Depression
Department of Veterans Affairs Department of Defense (VA/DoD)
Managing Depression in Primary Care

Diabetes
American Diabetes Association
American Diabetes Association Standards of Medical Care in Diabetes – 2023

Headache/Migraine (New December 2022)
Veterans Affairs/Department of Defense (VA/DoD)
The Primary Care Management of Headache

Heart failure
American Heart Association/American College of Cardiology/Heart Failure Society of America
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

ASCVD Risk Estimator Plus
American College of Cardiology
ASCVD Risk Estimator Plus

Hypertension
2020 International Society of Hypertension
2020 International Society of Hypertension Global Practice Guidelines

Insomnia (New December 2022)
Veterans Affairs/Department of Defense (VA/DoD)
The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea (Insomnia/OSA) (2019)

Kidney disease
National Kidney Foundation
Guidelines and Commentaries – Evidence-based clinical practice guidelines for all stages of chronic kidney disease

Please note: The National Kidney Foundation (NKF) is the copyright holder and owner of all content, videos, and images. As such, the National Kidney Foundation hereby grants permission to Humana to use NKF guidelines on Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines to place on the company's website on Clinical Practice Guidelines for their providers. NKF is providing permission for Humana to be able to link to the NKF guideline at www.kidney.org/professionals/guidelines/guidelines_commentaries. The National Kidney Foundation gives copyright permission for the use of the above guidelines content only and no use of other NKF images, charts, graphs, or content. Produced by the National Kidney Foundation, Inc. All rights reserved.

Opioid guidelines
Veterans Affairs/Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline for the use of Opioids in the management of chronic pain, PDF

Health and Human Services (HHS)
HSS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, PDF

Oxygen therapy
American Thoracic Society
Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline

Perinatal guidelines
A compilation of pediatric guidelines in an eBook resulting from a joint effort by The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP)
(AAP 2017 eBook collection) Guidelines for Perinatal Care, 8th edition (e-book collection)

Please note that selecting this link will take you to Availity Essentials (formerly Availity Portal). After signing in, select Humana from the “Payer Spaces” drop-down menu. Then select the “Resources” tab, in the center of the page that loads, to view the guidelines. You will see links to both the AAP Guidelines for Perinatal Care and the AAP eBook Collection.

If you do not have an Availity account, you can create one by selecting “Register” at the top of the Availity.com homepage

Preventive care
U.S. Preventive Services Task Force
USPSTF Guidelines – All Topics

Primary prevention of cardiovascular disease and stroke
ACC/AHA Task Force on Clinical Practice Guidelines
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Sickle cell anemia
NIH
Evidence-Based Management of Sickle Cell Disease: Expert Panel Report 2014

Sleep apnea
American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea
Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea

Telehealth
American Medical Association (AMA)
Digital health implementation playbook series

Urinary Incontinence (New December 2022)
Journal of Women’s Health
Female Urinary Incontinence Evidence-Based Treatment Pathways: An Infographic for shared decision-making

Transgender (New December 2022)
American College of Obstetricians and Gynecologists
ACOG Committee Opinion Health Care for Transgender and Gender Diverse Individuals

World Professional Association for Transgender Health
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Valvular heart disease
American College of Cardiology/American Association Joint Committee on Clinical Practice Guidelines
2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease

Well-woman routine care
The American College of Obstetricians and Gynecologists (ACOG)
Recommendations for Well-Woman Care 2022

Humana periodically monitors compliance with nationally recognized clinical practice guidelines.

*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 physician’s or other healthcare professional's clinical judgment and is not always applicable to an individual. Therefore, the physician or healthcare 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 physician or other healthcare professional regarding medically available treatment options for patients.

Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage to determine benefits.

Links to other websites are provided for your convenience only and do not constitute or imply endorsement by Humana of these sites, products or services described on these sites, or of any other material contained therein. Humana disclaims responsibility for their content and accuracy.