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Clinical Practice Guidelines

Meridian encourages the use of evidence-based Clinical Practice Guidelines (CPGs) by our providers. Our Quality Improvement Committee approves and adopts CPGs for prevention, diagnosis and management of medical and behavioral health conditions. These guidelines are developed by the nationally-recognized National Committee for Quality Assurance (NCQA), MQIC or other CPG developers to develop clinical strategies to monitor and evaluate the quality of care provided to Medicare beneficiaries.

NCQA guidelines are reviewed and updated quarterly, or more frequently if necessary. Once approved by NCQA Medical Directors, CPGs are sent to the National Guideline Clearinghouse (NGC) for inclusion on the US Department of Health and Human Services Agency for Healthcare Research and Quality. NGC prepares structured abstracts for consistency of guidelines on their website.

Meridian promotes implementation of these CPGs via dissemination among practitioners and uses numerous performance measures to provide feedback to achieve consistent and high quality health outcomes for our members. To view clinical practice guidelines visit the Meridian website.

The CPGs are reviewed at least every two years and updated as necessary by the Meridian Health Plan Physician Advisory Committee (PAC), and approved by Meridian’s Quality Improvement Committee and Board of Directors.

Please click below to view the guidelines in electronic format. They are also available in hard copy upon request by contacting the Medicare Quality Improvement department at 1-855-898-1470.

Recently Updated Clinical Practice Guidelines