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Clinical practice guidelines

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) 
Recommended immunization schedule for adults aged 19 years or older, United States 2024

Asthma
GINA ©2023 Global Initiative for Asthma, reprinted with permission. Available from www.ginasthma.org
Global Strategy for Asthma Management and Prevention, 2023

Atrial Fibrillation
National Institute for Health and Care Excellence (NICE)
Atrial fibrillation: diagnosis and management (2021)

Back Pain 
Department of Veterans Affairs Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline for the Diagnosis and Treatment of Low Back Pain, 2022

Cardiovascular Disease and Stroke
ACC/AHA Task Force on Clinical Practice Guidelines
ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, 2019

Childhood Immunizations
Centers for Disease Control and Prevention
Recommended immunization schedule for children and adolescents ages 18 years or younger, United States, 2024

Childhood Preventive Services
American Academy of Pediatrics
Recommendations for Preventive Pediatric Health Care – Bright Futures Periodicity Table, 2023

Cholesterol
Department of Veterans Affairs Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline: The Management of Dyslipidemia for Cardiovascular Risk Reduction (2020)

Chronic Obstructive Pulmonary Disease (COPD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
© 2024, Global Initiative for Chronic Obstructive Lung Disease, available from www.goldcopd.org, published in Deer Park, IL, USA.
Global Strategy for the Prevention, Diagnosis and Management of COPD, 2024 Report

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.
Guideline for the Management of COVID-19, 2023

Depression in adolescents
American Academy of Pediatrics
American Academy of Pediatrics Part 1 Guideline for Adolescent Depression in Primary Care (GLAD-PC), 2018
American Academy of Pediatrics Part 2 Guideline for Adolescent Depression in Primary Care (GLAD-PC), 2018

Depression
Department of Veterans Affairs Department of Defense (VA/DoD)
Managing Depression in Primary Care, 2020

Diabetes
American Diabetes Association
American Diabetes Association Standards of Medical Care in Diabetes – 2024

Headache/Migraine
Department of Veterans Affairs/Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline: Management of Headache, 2023

Heart failure
American Heart Association/American College of Cardiology/Heart Failure Society of America
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, 2022

ASCVD Risk Estimator Plus 
American College of Cardiology 
ASCVD Risk Estimator Plus

Human Immunodeficiency Virus (HIV) (new January 2024) 
HIV.gov
Adult and Adolescent Antiretroviral Agents
Adult and Adolescent Opportunistic Infections
Pediatric Antiretroviral Agents
Pediatric Opportunistic Infections
Perinatal HIV Guidelines
Caring for Persons with HIV in a disaster area
Guidance for COVID-19 and people with HIV
2018─2023

Hypertension
American College of Cardiology/American Heart Association/European Society of Cardiology/European Society of Hypertension Blood Pressure
Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology /European Society of Hypertension Blood Pressure/Hypertension Guidelines: Comparisons, Reflections, and Recommendations, 2022

Insomnia
Department of Veterans Affairs/Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline: The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea (Insomnia/OSA), 2019

Kidney disease
National Kidney Foundation
Guidelines and Commentaries – Evidence-based clinical practice guidelines for all stages of chronic kidney disease, 2024

Please note: The National Kidney Foundation (NKF) is the copyright holder and owner of all content, videos, and images. As such, the NKF hereby grants permission to Humana to use NKF guidelines on Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines to place on the company's website on Clinical Practice Guidelines for their providers. NKF is providing permission for Humana to be able to link to the NKF guideline at www.ajkd.org/content/kdoqiguidelines. NKF gives copyright permission for the use of the above guidelines content only and no use of other NKF images, charts, graphs or content. Produced by the National Kidney Foundation, Inc. All rights reserved.

Opioid guidelines
Centers for Disease Control and Prevention (CDC)
CDC Clinical Practice Guideline for Prescribing Opioids for Pain (CDC), 2022

Health and Human Services (HHS) 
HSS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, 2019

Oxygen therapy for adults
American Thoracic Society
Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline, 2020

Reprinted with permission of the American Thoracic Society.  
Copyright ©2024 American Thoracic Society. All rights reserved.  
Cite: Susan S. Jacobs, Jerry A Krishnan, David J Lederer, Marya Ghazipura, Tanzib Hossain, Ai-Yui M. Tan, Brain Carlin, M. Bradley Drummond, Magnus Ekstrőm, Chris, Garvey, Bridget A. Graney, Beverly Jackson, Thomas Kallstrom, Shandra L. Knight, Kathleen Lindell, Valentin Prieto-Centurion, Elissabetta A. Renzoni, Christopher J. Ryerson, Ann Schneidman, Jeffrey Swigris, Dona Upson, Anne E Holland,/2020/American Journal of Respiratory and Critical Care Medicine/Volume 202/Issue 10/e121-e141
The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.

Oxygen therapy for children (added January 2024)
American Thoracic Society
Home Oxygen Therapy for Children (2018)

Reprinted with permission of the American Thoracic Society.  
Copyright © 2024 American Thoracic Society. All rights reserved.   
Cite: Don Hayes Jr., Kevin C. Wilson, Katelyn Kirvchenia, Stephen M.M. Hawkins, Ian M. Balfour-Lynn, David Gozal, Howard B. Panitch, Mark L. Splaingard, Lawrence M. Rhein, Geoffrey Kurland, Steven H. Abman, Timothy M. Hoffman, Christopher L. Carrol, Mary E. Cataletto, Dmitry Tumin, Eyal Oren, Richard J. Martin, Joyce Baker, Gregory R. Porta, Deborah Kaley, Ann Gettys, Robin R. Deterding, /2018/American Journal of Respiratory and Critical Care Medicine/Volume 199/Issue 3/e5-e23 
The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.

Palliative care
National Coalition for Hospice and Palliative Care
Clinical Practice Guidelines for Quality Palliative Care, 4th edition, 2018

Perinatal Guidelines
A compilation of pediatric guidelines in an eBook resulting from a joint effort by The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP)
(AAP 2017 eBook collection) Guidelines for Perinatal Care, 8th edition (e-book collection)

Please note that selecting this link will take you to Availity Essentials™ (formerly Availity Portal). After signing in, select Humana from the “Payer Spaces” drop-down 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 selecting “Register” at the top of the www.availity.com homepage

Preventive Care
U.S. Preventive Services Task Force
USPSTF Guidelines – All Topics, 2024

Sickle cell anemia
NIH
Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014

Sleep apnea
American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea
Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea, 2014

Telehealth 
American Medical Association (AMA)
Digital health implementation playbook series

Transgender 
American College of Obstetricians and Gynecologists
ACOG Committee Opinion Health Care for Transgender and Gender Diverse Individuals, 2024

World Professional Association for Transgender Health
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, 2023

Urinary Incontinence
Journal of Women’s Health
Female Urinary Incontinence Evidence-Based Treatment Pathways: An Infographic for shared decision-making, 2022
National Institute for Health and Care Excellence (NICE)
Lower Urinary Tract Symptoms in Men 2015

Valvular Heart Disease
American College of Cardiology/American Association Joint Committee on Clinical Practice Guidelines
ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease, 2020

Well-Woman Routine Care
The American College of Obstetricians and Gynecologists (ACOG) 
Recommendations for Well-Woman Care (2023)

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.

Guidelines adopted by Humana

Patient care