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)
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Asthma care
Global Initiative for Asthma (GINA)
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Atrial fibrillation guidelines
AHA/ACC/Heart Rhythm Society
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Back pain
Institute for Clinical Systems Improvement
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Childhood immunizations
Centers for Disease Control and Prevention
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Cholesterol treatment
2018 AHA/ACC/American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)/ American Academy of Physician Assistants (AAPA) /Association of Black Cardiologists (ABC) /American College of Preventive Medicine (ACPM) / American Diabetes Association (ADA) / American Geriatric Society (AGS) / American Pharmacist Association (APpA) / American Society of Preventive Cardiology (ASPC) / National Lipid Association (NLA) / Preventive Cardiovascular Nurses Association (PCNA)
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Chronic obstructive pulmonary disease (COPD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
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Covid-19 (New August 2020)
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.
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Depression
Institute for Clinical Systems Improvement
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Diabetes
American Diabetes Association
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Heart failure
2017 ACC/AHA/Heart Failure Society of America (HFSA) Task Force on Clinical Guidelines
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Heart risk calculator
American College of Cardiology Foundation
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Hypertension
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA
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Kidney disease
National Kidney Foundation
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Opioid Guidelines
ICSI
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Health and Human Services (HHS)
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Perinatal guidelines
A compilation of pediatric guidelines in an eBook resulting from a joint effort by The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics (AAP)
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Please note that clicking on this link will take you to Availity Portal. After logging in, select Humana from the “Payer Spaces” dropdown 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. The link from Availity is , opens new window.
If you do not have an Availity account, you can create one by clicking the “Register” button at the top of the Availity.com homepage
Preventive care
U.S. Preventive Services Task Force
There are more than 100 guidelines on the USPSTF site. Humana recommends the following guidelines*:
- BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing – women with a personal or family history
- Breast Cancer
- Cervical Cancer
- Colorectal Cancer: Screening – Adults aged 50 to 75 years
- Interventions for Tobacco Smoking Cessation
- Obesity in Children and Adolescents: Screening
- Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions
*Some of these guidelines have multiple entries. Where that occurs, Humana recommends entries that USPSTF has graded A (high certainty that the net benefit is substantial) or B (high certainty that the net benefit is moderate or moderate certainty that the net benefit is moderate or substantial). Information about the USPSTF grading system can be found at , opens new window
Primary Prevention of Cardiovascular Disease and Stroke
ACC/AHA Task Force on Clinical Practice Guidelines
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Sickle cell anemia
NIH
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Valvular heart disease
AHA/ACC Task Force on Clinical Practice Guidelines
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Well-woman routine care
The American College of Obstetricians and Gynecologists (ACOG)
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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.