Clinical Practice Guidelines

CHIPA adopts Clinical Practice Guidelines (CPGs) from nationally recognized sources and scientific bodies (including professional organizations) based on:

  1. Scientific evidence
  2. Best practice standards, and
  3. Expert input from board certified physicians from appropriate specialties

Additionally, input may be gathered from practitioners, members and/or community agencies, especially when required by contract or regulation.

In accordance with the management service agreement with Carelon Behavioral Health Strategies, Carelon Behavioral Health’s Scientific Review Committee (SRC) reviews and/or updates each guideline at least every two years, or more often if:

  1. National sources publish updates or make changes to the guideline, or
  2. If more frequent review is required per contract or state requirement such as those plans in California that require guidelines to be evaluated, and updated if necessary, on an annual basis.

Once the updates/changes and recommendations are made by the SRC and approved by Carelon Behavioral Health, these changes are then brought before the CHIPA Executive Committee for final review, approval and adoption by CHIPA.

Click here to view the most current CPGs.

CHIPA has also adopted the following CPG:

Printed copies of all materials are available upon request. Please call 800-779-3825 to request a printed copy.