Clinical Practice Guidelines
Clinical Practice Guidelines (CPGs) and Preventive Care Guidelines are adopted by BCBSIL and are the foundation for selected Condition Management Programs. The guidelines are updated at least every 2 years. You may request a hard copy of the guidelines or provide feedback on the guidelines by calling the Quality Improvement Department at 312-653-3465.
The links below provide information about the CPGs.
- Cardiovascular Disease
2016 Clinical Practice Guidelines for Medicaid Plans (MMAI, ICP, FHP and MLTSS)
Clinical Practice Guidelines for Illinois Medicaid plans are adopted by BCBSIL through the Clinical Quality Committee and are the foundation for selected Condition Management Programs. The guidelines are reviewed annually and updated at least every 2 years. They are meant to serve as general guidelines and are not intended to substitute for clinical judgment in individual cases. The links below provide information about the CPGs.
- Behavioral Health Clinical Practice Guidelines
- Chronic Obstructive Pulmonary Disease (COPD) Guidelines
- Community Reintegration and Support
- Coordination of Community Support and Services for Enrollees of HCBS Waivers
- Dental Services
- Diabetes Clinical Practice Guideline
- Family Planning and Reproductive Care
- Guidelines for Heart Failure in the Adult
- Guidelines for Primary & Secondary Prevention of CAD
- Guidelines for Treating Tobacco Use and Dependence
- High Risk Pregnancy
- Long Term Care (LTC) Coordination of Care and Services
- Management of Routine Prenatal and Postpartum Care
- Preventative Care Guidelines