Provider tools

Clinical practice guidelines

Information on clinical practice guidelines approved by the Department of Medical Assistance Services (DMAS), Magellan Complete Care and other health organizations.

The external links are being provided as a convenience and for informational purposes. Such materials should be treated as educational resources to provide clinical practice recommendations, components of proper care, general treatment guidelines, and/or used to increase knowledge, and promote better management of patients. This information should not be considered as inclusive of all proper treatments or methods of care, and is not intended to substitute for the independent professional judgment of the treating clinician.

Allergy and Immunology

Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines: 2010 Revision

Diagnosis and Management of Food Allergy in the United States

Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America

Behavioral Health guidelines

Addiction and Recovery Treatment Services (ARTS)

Assessing and Managing the Patient with Suicidal Ideation

Assessing and Managing the Patient with Suicidal Ideation: Keeping the Patient with Suicidal Ideation Safe

Assessment and Treatment of Generalized Anxiety Disorder in Adults

Assessment and Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder, and Quick Reference Guide (2004); and the APA Guideline Watch: Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder (2009)

Assessment and Treatment of Patients with Post-traumatic Stress Disorder and Acute Stress Disorder

Attention Deficit and Hyperactivity Disorder (ADHD)

Diagnosis and Management of ADHD in Adults

Bipolar Disorder

The American Psychiatric Association (APA) Guideline Watch (November 2005): Practice Guideline for the Treatment of Patients with Bipolar Disorder, Second Edition

The American Psychiatric Association's (APA) Practice Guideline for the Treatment of Patients with Bipolar Disorder, Second Edition

Magellan’s Update of its Introduction to the American Psychiatric Association’s Clinical Practice Guideline for the Treatment of Patients with Bipolar Disorder

Depression

The American Psychiatric Association’s (APA) Practice Guideline for the Treatment of Patients With Major Depression, Third Edition

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): II. Treatment and Ongoing Management

Magellan’s Adopted Clinical Practice Guideline For the Assessment and Treatment of Patients With Major Depressive Disorder

Treating Depression in the Primary Care Setting

Eating Disorders

American Dietetic Association’s Position of the American Dietetic Association: Weight Management (2009)

American Psychiatric Association's (APA) Practice Guideline for the Treatment of Patients with Eating Disorders, Third Edition (2006) and Guideline Watch (August 2012)

Magellan’s Adopted Clinical Practice Guideline for the Assessment and Treatment of Patients With Eating Disorders

Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults (2016)

Obsessive-Compulsive Disorder

American Psychiatric Association’s (APA) Practice Guideline for the Treatment of Patients With Obsessive-Compulsive Disorder, First Edition (2007) and APA Guideline Watch (2013)

Treatment of Patients with Obsessive-Compulsive Disorder

Panic Disorder

American Psychiatric Association's (APA) Practice Guideline for the Treatment of Patients With Panic Disorder, Second Edition (January 2009) and the companion Quick Reference Guide

Magellan’s Adopted Clinical Practice Guideline for the Treatment of Patients with Panic Disorder 

Psychiatric Residential Treatment

American Academy of Child & Adolescent Psychiatry (AACAP) Principles of Care for Children in Residential Treatment Centers 

Building Bridges Initiative

Schizophrenia

American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients With Schizophrenia, Second Edition (2004), and Guideline Watch (2009)

American Psychiatric Association (APA) Guideline Watch for the Treatment of Patients with Schizophrenia (2009)

Magellan’s Adopted Clinical Practice Guidelines for the Treatment of Schizophrenia

Substance Use Disorder

Agency Medical Directors’ Group Interagency Guideline on Prescribing Opioids for Pain (2015)

American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder” (2018) American Psychiatric Association (2018)

American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Substance Use Disorders, Second Edition (May 2006)

American Psychiatric Association (APA) Treating Substance Use Disorders: A Quick Reference Guide (2006), and Guideline Watch (April 2007): Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd Edition

CAGE and CAGE-AID

Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Substance Use Disorders (2015)

Magellan’s Adopted Clinical Practice Guidelines for the Treatment of Substance Use Disorders

National Institute on Drug Abuse Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide (2014)

New England Journal of Medicine Treatment of Opioid Use Disorders (2016)

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Substance Use Disorders Identification Tip Sheet

Substance Use Screening Tools

Additional resources

Magellan Provider Guidelines

Cardiovascular guidelines

2013 ACCF/AHA Guideline for the Management of Heart Failure: Executive Summary

2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease

2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults

2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure

AHA/AACF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update

Clinician Guide to the ABCs of Primary and Secondary Prevention of Atherosclerotic Cardiovascular Disease

Evidence-Based Management of Sickle Cell Disease

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults

Diabetes guidelines

American Diabetes Association Standards of Medical Care in Diabetes—2018

Integrative care

Behavioral/Medical care coordination toolkit

Magellan of Virginia Coordination of Care: Behavioral Health and Primary Care Provider Collaboration 

Magellan of Virginia Coordination of Care: Behavioral Health and Primary Care Provider Collaboration recorded training

Magellan of Virginia Coordination of Care Between Behavioral Health and Primary Care Providers Frequently Asked Questions (FAQ)

Maternal care

American College of Obstetricians and Gynecologists (ACOG) Optimizing Postpartum Care

American Family Physician Update on Prenatal Care

MQIC Routine Prenatal and Postnatal Care

Obstetrics and gynecology guidelines

ACOG Perinatal Depression Screening

Centers for Disease Control and Prevention (CDC) Breast Cancer Screening

CDC Cervical Cancer Screening

Edinburgh Postnatal Depression Scale

Opioid treatment guidelines

CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016

Orthopedic guidelines

American College of Physicians (ACP) Treatment of Acute and Chronic Low Back Pain

American Society of Addiction Medicine (ASAM) National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use

Pediatric guidelines

American Academy of Child & Adolescent Psychiatry Parameters, Updates and Guidelines

Diagnosis, Evaluation, and Management of High Blood Pressure in Children and Adolescents

Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

Diagnosis and Management of Acute Otitis Media

Diagnosis, Management, and Prevention of Bronchiolitis

The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents

Health Supervision for Children With Down Syndrome (Reaffirmed by AAP in May 2018)

Key Points for Asthma Guideline Implementation

Neonatal Abstinence Syndrome

Palivizumab (Synagis) Criteria for Respiratory Syncytial Virus (RSV) Infection

Autism spectrum disorders

Identification and Evaluation of Children with Autism Spectrum Disorders

Magellan’s Adopted Clinical Practice Guidelines for the Assessment and Treatment of Children With Autism Spectrum Disorders

American Academy of Pediatrics (AAP) Practice Guideline for the Management of Children With Autism Spectrum Disorders

Pediatric Attention Deficit Hyperactive Disorder (ADHD)

American Academy of Child & Adolescent Psychiatry Practice Parameter for the Assessment and Treatment of Children and Adolescents With ADHD

American Academy of Pediatrics Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents

Preventive health guidelines

Bright Futures/AAP Periodicity Schedule

CDC Recommended Adult Immunizations Schedule for ages 19 years or older, 2019

CDC Immunization Schedule by medical conditions and other indications, 2019

CDC Recommended Child and Adolescent Immunization Schedule

Interventions to Prevent Falls in Community-Dwelling Older Adults

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement

The Virginia Department of Health (VDH) Immunization Information System

VDH Virginia Vaccines for Children Program (VVFC) 

Perinatal and pediatric preventive care

Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

As a fully integrated health plan, Magellan Complete Care of Virginia (MCC of VA) promotes wellness for its members and encourages providers’ involvement in managing members’ physical and mental health needs. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is an integral part of our wellness program. These visits include comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status) for eligible children from birth to 20 years old.   

As part of our commitment to ensuring members’ wellness, MCC of VA will reach out to the parents of newly enrolled child and adolescent members, as well as members with gaps in care, to assist with setting up an appointment with the child’s primary care physician for an EPSDT visit, if they have not already done so.   

MCC of VA is also reaching out to you, the primary care physician, to ask you to please contact your members to get their EPSDT visits scheduled and completed. Please review MCC of VA’s EPSDT program for information on MCC of VA’s EPSDT program and your provider responsibilities.

As part of their benefits, MCC of VA members receive transportation to and from visits through Veyo which can aid in members attending the EPSDT visit. Our Care Coordination team is also a resource for your practice and can be reached by calling 1-800-424-4524 for CCC Plus or 1-800-424-4518 for Medallion 4.0, if members need further assistance in arranging the EPSDT visit.

Additional information on EPSDT can be found in Magellan Complete Care of VA’s provider handbook. You can also find more information at the resources below:

EPSDT Specialized Services Guide for Providers

American Academy of Pediatrics (AAP) Bright Futures Recommendations for Preventative Pediatric Care

Additional resources

Department of Medical Assistance Services (DMAS) EPSDT Manual

AAP Recommendations for Preventive Pediatric Health Care

Agency for Healthcare Research and Quality

VDH Guidelines for Testing Children for Lead Exposure

Virginia Law Protocol for Identification of Children with Elevated Blood Lead Levels 

CDC Advisory Committee on Immunization Practices 2019 Immunization Schedules 

AAP Bright Futures

American Academy of Pediatric Dentistry (AAPD) Recommendations for Pediatric Oral Health Assessment, Preventive Services, and Anticipatory Guidance/Counseling

American Academy of Family Physicians (AAFP)

Pulmonary guidelines

Asthma

American Academy of Pediatrics- Virginia Chapter, Asthma Tool Kit and other resources

National Asthma Education and Prevention Program Asthma Care Quick Reference

Chronic Obstructive Pulmonary Disease (COPD)

Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 

Safety guidelines

Virginia Department of Social Services Adult Protective Services (APS)

Prevention of Falls in Older Persons: American Geriatric Society Clinical Practice Guidelines

Seatbelt and helmet safety

VDH Child Passenger Safety

Tobacco/smoking cessation

Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions

Virginia reportable disease list

VDH Reportable Disease List and Regulation