Clinical Practice Guidelines

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(Endorsed by B – UFC/ACC, and B – UFC/ALTCS)
Our health plans adhere to clinical practice guidelines and regularly review our guidance. 

Clinical Practice Guidelines are:

  • Based on valid and reliable clinical evidence or a consensus of health care professionals in that field;
  • Selected with consideration of the needs of our members;
  • Adopted in consultation with our providers;
  • Based on National Practice Standards and;
  • Developed by health care professionals and based on a review of peer‐reviewed articles published in the United States when national practice guidelines are not available;
  • Recommendations to support clinical decision‐making.

Primary care physicians, specialists, and other health care providers are expected to collaborate with their patient and/or the patient’s surrogate to develop and implement treatment plans that are individualized to meet the specific needs of each patient. This collaboration allows deviation from the guideline in unique clinical situations and should be clearly substantiated in the medical record.

Our clinical practice guidelines are endorsed or developed with designated, desired outcomes and associated, standardized measures of effectiveness. These guidelines are disseminated to all affected providers and are available to all providers, members, potential members and affiliated allied health professionals upon request.

Additional guideline resources are available through the National Guideline Clearinghouse 

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