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BMC HealthNet Plan (the Plan) adopts, develops and
implements Clinical Practice Guidelines (CPGs) relevant to its membership for
the provision of preventive and non-preventive acute and chronic clinical
services and for both medical and behavioral health conditions. For example,
the Plan adopted a CPG for asthma (as noted below) because of the high
prevalence of asthmatics in our covered population and our desire to reduce the
variation in the delivery of care across our network. The Plan adopts clinical
practice guidelines from national sources or develops guidelines in
collaboration with specialty organizations and/or regional collaborative
groups. CPGs serve as a means of establishing standards among providers in
medical and behavioral health to improve health outcomes and are not intended
to replace clinical judgment.
For a complete list of medications covered by BMC HealthNet Plan, visit our
online formulary. Click on the "Pharmacy" button at the top of this page.
BMC HealthNet Plan has endorsed the evidence-based guidelines developed by the
Massachusetts Health Quality Partners (MHQP). We encourage you to follow these
guidelines to deliver quality care to all of your patients and our members.
You can access these guidelines on the MHQP Web site, www.mhqp.org, or by clicking any of the
links below.
BMC HealthNet Plan endorses the National Asthma Education and Prevention Panel
Guidelines for Diagnosis and Management of Asthma.
BMC HealthNet Plan participated in updating the Massachusetts Guidelines for Adult Diabetes Care
that is based on the American Diabetes Association 2009 Clinical Practice
Recommendations. This guideline will assist in standardizing care to people
with diabetes.
CDC Recommendations and Guidelines
JAMA Guideline
Pediatric Environmental Home Assessment (PEHA).
BMC HealthNet Plan endorses the importance of home environmental assessments to
help members with their asthma management.
Massachusetts Lead Screening Prevention Program
Clinical Guideline for the Treatment of Depression in the
Primary Care Setting
Attention Deficit Hyperactivity Disorder (ADHD)
in Primary Care for Children and Adolescents (Institute of Clinical Systems
Improvement Guideline)
Bipolar Disorder
Schizophrenia
Treatment of substance abuse disorders:
BMC HealthNet Plan endorses the APA Guideline for the treatment of patients with
substance abuse disorders. In addition to the opiate programs listed in the
guideline, certified suboxone prescriber offices are included as additional sites for suboxone care.
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