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)
Asthma care
Global Initiative for Asthma (GINA)
Atrial fibrillation guidelines
AHA/ACC/Heart Rhythm Society
Back pain
Institute for Clinical Systems Improvement
Chemical dependency placement criteria
American Society of Addiction Medicine
Humana utilizes the criteria developed by the American Society of Addiction Medicine (ASAM).
Childhood immunizations
Centers for Disease Control and Prevention
Childhood Preventive Services (Added July 2021)
American Academy of Pediatrics
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)
Chronic obstructive pulmonary disease (COPD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
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.
Depression
Institute for Clinical Systems Improvement
Diabetes
American Diabetes Association
Heart failure
The American College of Cardiology/American Heart Association Task Force on Performance Measures
Heart risk calculator
American College of Cardiology Foundation
Hypertension
2020 International Society of Hypertension
Kidney disease
National Kidney Foundation
Opioid Guidelines
ICSI
Health and Human Services (HHS)
Oxygen Therapy (added July 2021)
American Thoracic Society
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)
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.
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
Primary Prevention of Cardiovascular Disease and Stroke
ACC/AHA Task Force on Clinical Practice Guidelines
Sickle cell anemia
NIH
Sleep apnea
American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea
Valvular heart disease
American College of Cardiology/American Association Joint Committee on Clinical Practice Guidelines
Well-woman routine care
The American College of Obstetricians and Gynecologists (ACOG)
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.